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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Factors associated with surgical intervention in osteoarthritis of the thumb carpometacarpal joint

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  • presenting/speaker Ken Nishimura - The University of Tokyo Hospital, Tokyo, Japan
  • Kosuke Uehara - The University of Tokyo Hospital, Tokyo, Japan
  • Sakae Tanaka - The University of Tokyo Hospital, Tokyo, Japan
  • Yutaka Morizaki - The University of Tokyo Hospital, Tokyo, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-139

doi: 10.3205/19ifssh0936, urn:nbn:de:0183-19ifssh09362

Published: February 6, 2020

© 2020 Nishimura et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: It is unclear which patients will require future surgery for osteoarthritis of the thumb carpometacarpal (CM) joint. This study aimed to analyze factors associated with surgical intervention in osteoarthritis of the thumb CM joint noted at the first visit.

Methods: Patients who visited our hand surgery outpatient clinic between May 2012 and January 2015, were diagnosed with osteoarthritis of the thumb CM joint, and were followed up for >3 years were included in this study. A total of 47 patients (80 thumbs; 10 men [15 thumbs], 38 women [65 thumbs]; mean age, 63 years) were included. Patients were divided into a group that had surgery within 3 years or a group that did not have surgery within 3 years. Sex, age, age at onset, disease duration, dominant hand, pain visual analog scale (VAS) score (resting and during use), night pain, Eaton classification, presence of orthosis, number of injections, tender part, range of motion, grip strength, pinch strength, Kapandji abduction index, palmar abduction distance, grind test results, CM joint shape on an X-ray, dorsal subluxation ratio, volar tilt, CM joint space distance, osteophyte presence, osteophyte size, and presence or absence of ossicles were extracted as variables. Univariate analysis was performed of the variables described above and a logistic regression was performed of the variables with values of p < 0.05 with the objective variable being whether surgery was performed.

Results and Conclusions: Resting pain VAS (p = 0.021), during use pain VAS (p = 0.043), dorsal subluxation ratio (p = 0.006), and presence of ossicles (p = 0.048) were significantly associated with surgical intervention on univariate analysis. Logistic regression analysis using these factors as explanatory variables revealed that resting pain VAS and dorsal subluxation ratio were significantly associated with surgical intervention.

In patients with osteoarthritis of the thumb CM joint, resting pain VAS and dorsal subluxation ratio at the first visit were associated with future surgical intervention within 3 years. This information may be useful for predicting future surgery during the first visit.