Pain,function, and radiographic disease in trapeziometacarpal osteoarthritis |
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| Affiliation: | 1. Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia;2. Macquarie University Clinic, Macquarie Hand Therapy, Macquarie University, New South Wales, Australia;3. Department of Physiotherapy, Centre for Health, Exercise, and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia;4. Physiotherapy Department, Royal North Shore Hospital, Sydney, New South Wales, Australia;5. Department of Musculoskeletal Imaging, Castlereagh Sports Imaging Centre, St. Leonards, Sydney, Australia;1. Physiotherapy department, SARAH Rehabilitation Hospital Network, Brasilia, Brazil;2. Neurosurgery department, SARAH Rehabilitation Hospital Network, Brasilia, Brazil;3. Psychology department, SARAH Rehabilitation Hospital Network, Brasilia, Brazil;4. Nursing department, SARAH Rehabilitation Hospital Network, Brasilia, Brazil;5. Pedagogy department, SARAH Rehabilitation Hospital Network, Brasilia, Brazil;1. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey;2. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muş Alparslan University, Muş, Turkey;1. Queen Margaret Hospital, Dunfermline, Scotland;2. Fife Virtual Hand Clinic, Dunfermline, Scotland.Department of Plastic Surgery, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK;3. Department of Plastic Surgery, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust;4. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK;1. Department of Orthopaedics, Cedars-Sinai Medical Center, 444 S San Vicente Blvd Suite 603, Los Angeles, California;2. Pro Rehab with Mo, Redondo Beach, California;1. Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, USA;2. Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA |
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| Abstract: | IntroductionTrapeziometacarpal joint osteoarthritis (OA) produces significant functional impairment due to pain and loss of strength in both power and precision grips, but few studies have related radiographic scores to functional and pain-based measures.PurposeTo investigate the association between markers of radiographic disease and outcomes for symptomatic and functional disease.Study DesignThis study in an exploratory analysis of baseline data from the first 100 participants in a clinical trial evaluating the efficacy of combined conservative therapies for base of thumb OA (COMBO).MethodsFunctional Index for Hand Osteoarthritis (FIHOA) scores and Visual Analogue Scale (VAS) scores for pain were recorded for the index hand. Bilateral isometric grip and tip-pinch strength measurements were taken, as well as posteroanterior and Eaton stress-view hand radiographs. Generalized estimating equations (GEEs), univariate, and multivariate analyses were used according to whether the data were bilateral or unilateral.ResultsA total of 79 females and 21 males were included, with a median Kellgren-Lawrence (KL) grade of 3 in the index hand. Higher KL and Eaton grades were associated with lower grip strength in the GEE analysis (B-coefficients of -1.25 and -1.16, and P-values of .002 and .010, respectively). Higher KL grade was also associated with poorer function and higher pain levels in the multivariable analysis (B-coefficients of 1.029 and 3.681, and P-values of .021 and .047, respectively). Lower radial subluxation ratios were associated with lower grip strength in the GEE analysis, and higher pain scores in the multivariable analysis (B-coefficients of 2.06 and -42.1, and P-values of .006 and .031, respectively). Greater pain scores were also associated with poorer function (B-coefficient 0.082, P-value .001).ConclusionMore advanced radiographic trapeziometacarpal OA severity is associated with lower grip strength and poorer self-reported functional outcomes. Lower subluxation ratios were associated with higher pain scores and lower grip strength. |
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