Joint Preserving Treatments for Thumb CMC Arthritis

Spielman, Amanda; Lessard, Anne-Sophie

doi:10.1016/j.hcl.2022.01.002

Cited by 8 publications

(8 citation statements)

References 35 publications

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“…In some studies, 5,[14][15][16] this pain reduction was statistically significant, with a p-value of less than 0.05. Other studies 3,4,[10][11][12][13]18 did not report p-values, although a reduction in pain was reported. No statements can therefore be made about whether this reduction in pain was statistically significant.…”

Section: Discussionmentioning

confidence: 93%

“…The literature overview showed that the majority of studies [3][4][5][10][11][12][13][14][15][16]18 reported pain reduction postoperatively. In some studies, 5,[14][15][16] this pain reduction was statistically significant, with a p-value of less than 0.05.…”

Section: Discussionmentioning

confidence: 99%

“…The Critical Appraisal Tools of the Joanna Briggs Institute [5][6][7][8][9] were used to critically appraise all the included articles, except for the article of Spielman et al, 10 because it was a kind of a scoping review. For this type of research, the Joanna Briggs Institute has not developed a Critical Appraisal Tool.…”

Section: Critical Appraisalmentioning

confidence: 99%

“…Salibi et al 17 reported no statistically significant pain reduction. The remaining studies 9,10,12,13,16,18,19 did not mention p-values, but did make statements about pain reduction.…”

Section: Visual Analog Scalementioning

confidence: 99%

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Thumb Carpometacarpal Joint Denervation for Early Osteoarthritis: An Overview of the Literature and a Pilot Study on Pain Reduction and Patient Satisfaction

Berkhout,

Bosch,

Ritt

2023

J Wrist Surg

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Background The treatment of patients with osteoarthritis of the first carpometacarpal joint (CMC-I) aims at pain reduction to improve hand function and quality of life. The CMC-I denervation procedure is relatively new and seems appealing, as it is minimally invasive and has few or no disadvantages. To date, however, little research has been done on the results of a CMC-I denervation. The aim of this study was to investigate whether denervation provides pain reduction in patients with early CMC-I osteoarthritis. Methods A literature search was done using PubMed. Studies were excluded if access to full text was not available, if the articles were written in other languages than Dutch or English, and if preoperative testing, follow-up testing, or reporting were incomplete. Studies were included if patients were older than 18 years, had primary CMC-I osteoarthritis with no other wrist pathology, and had received conservative treatment without sustained benefit. The Critical Appraisal Tools of the Joanna Briggs Institute were used for critical appraisal.Clinical data was gathered retrospectively from the medical records to identify patients who underwent CMC-I denervation in The Hand Clinic, Amsterdam. The data of 20 patients were analyzed. Pre- and postoperative visual analog scale (VAS) scores on pain, patient satisfaction, and complications were evaluated. Patients older than 18 years with primary CMC-I osteoarthritis stage I and II and no other wrist pathology, in whom conservative treatment failed were included in the study. Patients with CMC-I osteoarthritis stage III and IV were excluded. Results All 17 search results were screened for full text access, after which 6 case series, 4 systematic reviews, 1 cohort study, 1 comment, and 1 scoping review was included. All but one study showed pain reduction after surgery. In half of the studies, this difference was statistically significant. The average patient satisfaction in these studies was 84.1% and the complication rate was 13.4%.A total of 20 patients were included between 2019 and 2022, with a mean preoperative VAS for pain at rest of 48.2 ± 29.9. After surgery, this decreased to 35.8 ± 34.1. This difference was not statistically significant. The mean VAS for pain during use before denervation was 79 ± 18.4 and this decreased to 49.8 ± 34.2 postoperatively. This difference did appear to be statistically significant. The average patient satisfaction was 60%, and the complication rate was 10%. Conclusion This study provides a literature overview and a pilot study on pain reduction, patient satisfaction, and complications after denervation of the CMC-I joint in patients with early osteoarthritis. Our retrospective case series roughly mirrored the average results found in the literature. There was a statistically significant decrease in pain during use postoperatively. There was no statistically significant difference in pain at rest before and after surgery. The complications were mild and the complication rate was low; however, the average patient satisfaction rate was lower as compared to that reported in the literature.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Critical Appraisalmentioning

confidence: 99%

“…Salibi et al 17 reported no statistically significant pain reduction. The remaining studies 9,10,12,13,16,18,19 did not mention p-values, but did make statements about pain reduction.…”

Section: Visual Analog Scalementioning

confidence: 99%

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Thumb Carpometacarpal Joint Denervation for Early Osteoarthritis: An Overview of the Literature and a Pilot Study on Pain Reduction and Patient Satisfaction

Berkhout,

Bosch,

Ritt

2023

J Wrist Surg

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“…Surgeries performed for advanced osteoarthritis of the thumb basal joint and their complications mainly comprise denervation, metacarpal osteotomy and joint stabilization (Rath et al, 2023;Spielman et al, 2022;Suresh et al, 2023). The risk profile associated with these methods is different and often involves another patient population.…”

Section: Introductionmentioning

confidence: 99%

Basal thumb arthritis surgery: complications and its management

Herren

2024

J Hand Surg Eur Vol

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The management of complications after surgery for basal thumb arthritis is sometimes challenging, and there are no clear recommendations on how to evaluate and manage patients with residual symptoms. The aim of the present article was to review the most common complications after surgery for basal thumb arthritis, with an emphasis on resection arthroplasty, joint replacement and joint fusion. In addition, possible management strategies for the different types of complications will be highlighted.

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