Nonoperative treatment showed positive 5-year results for patients with carpometacarpal OA
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Key takeaways:
- Nonoperative treatment for patients with carpometacarpal OA did not worsen pain or limitations in activities of daily living at minimum 5-year follow-up.
- Results indicate that treatment effects are sustainable.
According to published results, patients managed with nonoperative treatment for thumb carpometacarpal joint osteoarthritis had no worsening pain or limitations in activities of daily living at a minimum 5-year follow-up.
Lisa M.J. Esteban Lopez, MSc, PT, and colleagues from the Hand-Wrist Study Group performed a multicenter, prospective cohort study of 170 patients who received nonoperative treatment for thumb carpometacarpal joint OA. According to the study, nonoperative treatment consisted of exercise therapy and use of an orthosis.
Outcome measures included the Michigan Hand Outcomes Questionnaire (MHQ) subscale for pain and activities of daily living (ADL) at 1-year and minimum 5-year timepoints.
Among patients who received nonoperative treatment, MHQ pain scores did not differ significantly from 1-year follow-up to minimum 5-year follow-up. MHQ ADL scores improved by 4.4 points from 1-year follow-up to a median follow-up of 6.6 years; however, researchers noted this was not clinically relevant.
At a minimum 5-year follow-up, researchers found 5% of patients rated their satisfaction as poor, 14% rated their satisfaction as moderate, 26% rated their satisfaction as fair, 39% rated their satisfaction as good and 16% rated their satisfaction as excellent. At a median follow-up of 7 years, the rate of conversion to surgery was 22%.
“Our findings support nonsurgical treatment as the first treatment choice and indicate that treatment effects are sustainable,” the researchers wrote in the study.