gms | German Medical Science

Research question: Trapeziometacarpal osteoarthritis, a debilitating hand condition, elicits pain, stiffness, and weakness, leading to compromised hand function and strength. Non-surgical interventions mainly comprise activity modifications, administration of nonsteroidal anti-inflammatory drugs (NSAIDs), splinting, and corticosteroid injections. Following unsuccessful conservative treatment, various surgical techniques are available.

ChondroFiller Liquid^®, a cell-free collagen scaffolds made from type I collagen and chondrostimulating factors, is utilized to form a protective layer around cartilage defects. It stimulates chondrocyte growth, facilitating cartilage regeneration and is specifically indicated for repairing cartilage lesions with a small surface area. A previous study demonstrated that ChondroFiller Liquid^® effectively alleviates painful symptoms, enhances grip strength (assessed via the Jamar test and pinch test), improves Patient-Reported Outcome Measures (PROMs) as indicated by the Disabilities of the Arm, Shoulder, and Hand (DASH) score, and reduces MRI-assessed bone edema and periarticular effusion in patients with rhizoarthrosis during a 12-month follow-up period. This study extends the follow-up to 24 months to assess the sustainability of clinical improvements.

Methods: Forty patients from the initial study were enrolled, categorized into two severity groups according to the joint degeneration on X-rays. At 18 months post-infiltration (time 1), all patients underwent clinical re-evaluation using the Numeric Rating Scale (NRS) and DASH score. Subsequent re-evaluation at 24 months post-infiltration (time 2) included the Jamar test, Pinch test, NRS, and DASH score. In addition to these patients, an additional 51 patients underwent infiltration with a mean follow-up of 14 months, of which 9 had already been treated in the preliminary study.

Results and conclusion: The findings indicate a sustained improvement in pain symptoms, coupled with increased strength in pincer and grip movements observed through clinical tests at the 18-month mark. However, a subset of patients demonstrated a reduction in clinical benefits during the 24-month follow-up.

ChondroFiller Liquid^® emerges as a viable alternative to surgery, demonstrating efficacy in mitigating the progression of painful symptoms and functional limitations, even in the long term. The observed clinical improvements support the use of infiltrative approaches, potentially delaying or obviating the need for subsequent surgical interventions.