gms | German Medical Science

Objectives/Interrogation: Trapeziometacarpal joint osteoarthritis can illicit a significant burden for afflicted patients. Amongst different treatment options, trapeziectomy with ligament reconstruction and tendon interposition (LRTI) has been shown to produce positive outcomes in terms of pain relief and function. Although considered safe by most surgeons, postoperative complications persist and the decision to undergo this procedure should take into account the patient's characteristics, baseline function and expectations. This study aims to gain more knowledge on the patient-reported functional outcomes and the utility measures of trapeziectomy with LRTI in the treatment of thumb osteoarthritis.

Methods: A survey was administered on consecutive patients who had underwent trapeziectomy with LRTI. Collected data consisted of demographic characteristics, the natural history of disease, the type of treatment received, the postoperative rehabilitation, the brief Michigan Hand Outcome Questionnaire (bMHQ) and the utility assessment questionnaires including the visual analogue scale (VAS), the time trade-off (TTO) and the standard gamble (SG) techniques. Quality adjusted life years (QALYs) were derived from these measures.

Results and Conclusions: In total, 32 patients were enrolled in this study, with a mean age of 60.8 years. Right-hand dominance was reported in 84% of patients, and the operated hand was the same as the dominance in 37.5%. Occupation was equally distributed between manual laborers and office/other at 25% each, whereas the other half was retired. A similar proportion of patients took more than two months of work leave (40.6%) and did not take any time off (34%). A significant majority of patients (84%) considered their operation to have been successful.

The mean normalized measure for patient-reported hand function on the bMHQ was calculated at 83.01. For utility measures, the VAS, SG and TTO produced a score of 0.2708, 0.7546, and 0.8350, respectively. The VAS, TTO and SG utility measures were significantly higher when patients perceived their operation to be successful (p=0.001). These utility health values translated into a mean of 37.73 QALYs for SG and 41.75 QALYs for TTO.

This is the first to study to quantify patients' reported outcomes and utility measures after undergoing trapeziectomy with LRTI. Reporting these health burden values will serve as comparison with other disease states and provide further insight for policy makers to advocate for this type of procedure.