Arthrodesis of the Carpometacarpal Thumb Joint for Osteoarthritis; Long-Term Results Using Patient-Reported Outcome Measurements

Abstract

Background Results following carpometacarpal (CMC) arthrodesis of the thumb for osteoarthritis vary widely in literature. Data on long-term patient-reported outcome measurements (PROMs) after thumb CMC joint arthrodesis for osteoarthritis are scarce.

Purpose We report the long-term outcomes of PROMs (function, pain, and satisfaction) after arthrodesis of the thumb CMC joint. We evaluated the correlation of function and pain with patient satisfaction.

Methods Long-term PROMs after thumb CMC arthrodesis for osteoarthritis were evaluated using a retrospective cohort (1996–2015). Three different PROM questionnaires (Disabilities of the Arm, Shoulder, and Hand Questionnaire, Dutch Language version [DASH-DLV], the Patient-Related Wrist and Hand Questionnaire Dutch Language version [PRWHE-DLV], and a questionnaire concerning satisfaction) were sent to all patients.

Results Twenty-five arthrodeses (21 patients) were available for long-term follow-up. The median follow-up time was 10.8 years (interquartile range [IQR]: 9.7–13.0). The median DASH score was 29.2 (IQR: 14.4–38.3), median PRWHE score was 25.0 (IQR: 12.5–44.3). The median satisfaction after the operation and satisfaction with outcome of the operation was 10 for both (on a Likert's scale with 1 worse and 10 excellent satisfaction). There was a statistically significant correlation between the PRWHE total score and PRWHE pain score and satisfaction with surgery and satisfaction with the result. There was no correlation between PRWHE function score and satisfaction or DASH and satisfaction. Results after hardware removal showed no significant differences compared with patients without hardware removal.

Conclusion Patients who underwent arthrodesis for thumb CMC osteoarthritis showed high satisfaction at long-term follow-up, despite moderate results as measured using the DASH and PRWHE. The PRWHE total and PRWHE pain scores correlated significantly with satisfaction with surgery and satisfaction with the result, respectively, whereas no correlation was observed with the PRWHE function score or DASH and satisfaction. This therapeutic study reflects level of evidence IV.

Keywords

arthrodesis - carpometacarpal osteoarthritis - basal thumb joint - patient-reported outcome measurements

Note

The research was performed with patients of the Division of Plastic and Hand Surgery, University Medical Center Utrecht, Utrecht, the Netherlands. Approval of the local scientific committee of the University Medical Center Utrecht was obtained.

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