Long-term effects of carpometacarpal joint arthrodesis on pain, clinical functions and quality of life

Abstract

The aim of this study was to evaluate the effect on pain and functional results, and potential complications, of arthrodesis applied to the carpometacarpal (CMC) joint of the thumb because of osteoarthritis. This single-centre, retrospective study included patients who presented at the polyclinic between 2003 and 2018 with complaints of pain and/or deformity at the base of the thumb, clinically and radiographically consistent with osteoarthritis of the CMC joint of the thumb. Before treatment and at the final examination, pain at rest and during activity (daily living activities) was evaluated with a visual analog scale (VAS), and the functional results were evaluated with the patient-reported DASH and PRWE scores. The study included 26 patients with a mean age of 55.4 years and mean follow-up period of 8.3 ± 4.1 years. Surgery was performed on the dominant hand in 73.1% of the patients. A significant improvement was determined postoperatively with mean VAS score of 3.5 (IQR: 2 - 5), mean DASH score of 26.1 (IQR: 20.5- 37.0), and mean PRWE score of 22.5 (IQR: 15.1–29.6). In the cases with surgery applied to the non-dominant hand, no significant correlation was determined postoperatively between the PRWE function score and VAS (p=0.053). In one patient applied with revision surgery with autograft because of pseudarthrosis during follow-up, there were complaints of pain because of the development of osteophytes. Patients applied with arthrodesis for osteoarthritis of the thumb CMC joint, showed a high level of satisfaction in the long-term follow up measured with DASH and PRWE. In the light of these results, arthrodesis for osteoarthritis of the thumb CMC joint can be evaluated as a reliable and effective treatment method.