Mission & plans
Why HAND exists, what it will do and how it is funded
Mission and vision
Independent, collaborative and transparent
Improve outcomes for people with hand and wrist arthritis through independent education, collaborative research and transparent evaluation of arthroplasty, supporting informed treatment choices and safe surgical practice.
Every patient has access to evidence-informed advice and skilled care, with reliable knowledge of recovery, implant durability and alternatives across health systems.
Why HAND is needed
New implants keep arriving. Long-term evidence has not kept up.
Implants and techniques for the finger, thumb and wrist continue to evolve, but long-term evidence is often limited and scattered across countries, registries and industry-sponsored series. A 2024 review of four randomised trials of thumb joint replacement found that early benefits had narrowed by one year, and the long-term risk of revision remains uncertain.
Patients and surgeons need independent, comparable information to choose the right treatment. HAND connects experienced centres so that outcomes and complications are defined, recorded and shared in the same way across implants and countries.
We start with thumb carpometacarpal (CMC) replacement, then extend to finger and wrist arthroplasty. Non-operative care, trapeziectomy and arthrodesis are included as comparators, because arthroplasty should be judged against the alternatives.
Source: Liukkonen et al., Acta Orthopaedica, 2024.
Objectives
Seven aims
Evidence
Generate robust clinical evidence on the indications, outcomes, complications and longevity of hand and wrist arthroplasty.
Education
Improve training in primary and revision arthroplasty through meetings, courses, webinars, operative videos and fellowships.
Collaboration
Connect surgeons and centres with significant experience in hand and wrist arthroplasty.
Standardisation
Develop common definitions, outcome measures and reporting standards.
Innovation
Create a constructive environment in which surgeons, engineers, researchers and manufacturers can develop and evaluate new technologies.
Surveillance
Develop ways to monitor implant performance and identify complications or failure patterns.
Research
Build an international platform able to deliver multicentre prospective studies, registries and clinical trials.
Activities
What the network will do
Meetings and courses
- An annual meeting, with the General Assembly held alongside it or a major international congress
- Courses, including hands-on training, and sessions at international congresses
- Launch at the BSSH Hand & Wrist Arthroplasty Course, Manchester, May 2027
Online learning
- Peer-reviewed learning modules and webinars on patient selection, technique, rehabilitation and revision
- A searchable library of operative videos, recordings and patient resources
- A monthly digest and a yearly summary of the latest hand arthroplasty publications
- Core education kept free
Research and evidence
- A core dataset and outcome set: pain, function, recovery, complications, reoperations and implant survival
- Multicentre studies and links with national implant registries
- Transparent, independent evaluation of implants and their alternatives, including negative findings
- Every study run under its own protocol, ethics approval and data-governance arrangements
Community and patients
- A difficult cases discussion forum for members
- Balanced, patient-reviewed information on arthroplasty and its alternatives
- Continental Ambassadors in six regions, with a welcome for early-career colleagues and under-represented regions
- Cooperation with FESSH, including support for a proposed Hand Arthroplasty Special Interest Group
First-year plan
Measurable goals for the first twelve months
| Objective | Deliverable and measure |
|---|---|
| Build the network | By day 90 Engage 10 centres in at least 5 countries and nominate education and research leads. |
| Improve education | By month 12 Publish 6 peer-reviewed learning modules and deliver 4 webinars covering selection, technique, rehabilitation and revision. |
| Create comparable evidence | By month 6 Agree a core dataset and protocol. By month 12 Pilot it at 5 centres, subject to approvals, aiming for at least 80% follow-up completeness. |
| Include patients and report openly | By month 3 Recruit patient and hand therapy advisers. Publish a patient-reviewed treatment explainer and annual reports on activity, funding and conflicts of interest. |
Organisation
How HAND is run
HAND is being established as a not-for-profit scientific association under Swiss law. It is politically neutral, independent of commercial interests and works in English.
General Assembly
All Full Members, one vote each. Elects the Steering Committee, approves the accounts and budget, and sets membership fees.
Steering Committee
Three to five elected members, including a Chair, Secretary and Treasurer, serving three-year terms with a balance of region, discipline, gender and career stage.
Operational Committee
Delivers the annual work plan, with committee chairs, an early-career member, the Ambassadors' coordinator and the FESSH Liaison Officer.
Committees
Website and Communications from the start, with Scientific and Research, and Education and Training committees as activity grows.
Continental Ambassadors
Regional contacts for Europe, Asia, North America, Central and South America, Africa, and Australia and the Pacific.
FESSH liaison
A dedicated officer works with the Federation of European Societies for Surgery of the Hand. Each organisation keeps its own governance.
Membership
Who can join
Membership is open to anyone with a professional interest in hand and wrist arthroplasty: surgeons and other doctors, hand therapists, allied health professionals, researchers, scientists and engineers.
- Full Members are professionally qualified and have voting rights.
- Associate Members include trainees and students, without a vote, and can move to Full membership.
- Honorary Members are appointed for outstanding service to the field.
Companies are not members. They may support HAND as Supporting Partners under written agreements, without any role in governance.
Member benefits
- A reduced registration fee for the annual meeting
- Access to the network's online publications
- A yearly summary of the latest hand arthroplasty literature
- Access to the difficult cases discussion forum
- Voting rights and the right to submit proposals at the General Assembly (Full Members)
- Access to the member directory, with each member's consent
€150 a year, proposed. Fees are set by the General Assembly, and may be reduced or waived for early-career members and colleagues from low- and middle-income countries.
Funding
How we plan to fund HAND
A mix of income sources, so that no single funder can shape the network. All income is used for HAND's purposes and nothing is distributed to members.
Membership fees
The core, recurring income from individual members.
Meetings and courses
Registration income from the annual meeting, courses and educational activities.
Industry grants
Pooled, unrestricted educational grants invited from current and future implant manufacturers on the same, non-exclusive terms.
Research grants
Project and research funding for multicentre studies and registry work.
Donations and legacies
Gifts from individuals and institutions that share the mission.
Publications
Income from publications and other activities consistent with HAND's purpose.
The money pays first for the website and digital services, a professional secretariat and the administration of membership. Education and research are then costed by the Treasurer and approved in the annual budget.
Our rules on independence
- HAND alone decides faculty, curriculum, research design, analysis and publication, including negative findings.
- Supporters receive no product endorsement, no preferential access to members or patient data, and no veto over publication.
- Every supporter, amount and use is published, and all industry income is disclosed in the annual report.
- Income from any single company is to be capped as a share of total income.
- Committee members declare their interests on appointment and every year. Those with a royalty or design interest in an implant cannot lead its evaluation.
- Education is kept separate from promotion, and sponsor acknowledgements are kept separate from clinical recommendations.
HAND is in its founding phase. Its bylaws, membership fees and policies are in draft and will be confirmed by the founding members and the first General Assembly.