Concomitant interventions may affect carpometacarpal arthroplasty outcomes
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BOSTON — Patients who underwent carpometacarpal arthroplasty with concomitant treatment of metacarpophalangeal hyperextension showed less improvement in QuickDASH scores postoperatively, data presented here showed.
At the American Society for Surgery of the Hand Annual Meeting, Fritz Steuer, BS, presented results of a retrospective study of the correction of concomitant conditions among 214 patients who underwent carpometacarpal (CMC) arthroplasty — 49 patients had scaphotrapezialtrapezoid (STT) arthritis and 68 patients had metacarpophalangeal (MCP) hyperextension.
The most common interventions associated with these concomitant conditions include hemitrapeziodectomy, tendon transfer, capsulodesis or fusion. Among the patients with MCP hyperextension, 63 patients underwent tendon transfers and 5 patients underwent fusions, according to Steuer, who is a medical student at the University of Pittsburgh.
“Patients undergoing CMC arthroplasty with MCP hyperextension requiring concomitant surgical intervention had significantly less improvement in QuickDASH scores in the early postoperative period, while concomitant intervention for STT arthritis did not impact QuickDASH scores in the early postoperative period,” Steuer said.
He continued, “This may provide appropriate expectations for patients with concomitant MCP hyperextension or STT arthritis undergoing CMC arthroplasty.”
Patients in the retrospective study were treated between 2017 and 2020. Steuer and colleagues evaluated patient-reported outcomes (PROs) and hypothesized there would be no difference in PROs when CMC arthroplasty was performed with concomitant treatment for either STT arthritis or MCP hyperextension.
Change in QuickDASH scores at the preoperative and 2-week and 6-week timepoints was the primary study outcome. Secondary outcomes were patient-reported outcomes measurement information system (PROMIS) PROMIS physical and mental scores reported at the same timepoints.
Discussing QuickDASH scores, Steuer said, “The difference for preoperative and 2 weeks for MCP hyperextension was 26 and [it was]13 for without MCP hyperextension, and at 6 weeks, MCP hyperextension correction was 5.7 compared to -8.39, both of which were statistically significant.”
By comparison, the difference in QuickDASH scores among patients who underwent concomitant STT arthritis treatment was 22 at 2 weeks vs. 19 in patients without the treatment and -5.4 at 6 weeks postoperatively compared to -1.9 in patients without STT arthritis treatment, “neither of which were statistically significant,” he said.
Differences at 2 weeks and 6 weeks postoperatively in the two types of PROMIS scores the researchers analyzed for both conditions treated concomitantly with CMC arthroplasty were not statistically significant, results showed.
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Steuer F, et al. Paper 4. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 29-Oct. 1, 2022; Boston.
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