Risk factors for limited improvement after total trapeziometacarpal joint arthroplasty

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Risk factors for limited improvement after total trapeziometacarpal joint arthroplasty. / Mosegaard, Sebastian Breddam; Stilling, Maiken; Hansen, Torben Bæk.

In: Health and Quality of Life Outcomes, Vol. 18, No. 1, 90, 30.03.2020.

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@article{2428ad22e2494cf3a48610cd7564f0fc,
title = "Risk factors for limited improvement after total trapeziometacarpal joint arthroplasty",
abstract = "BACKGROUND: Trapeziometacarpal (TMC) osteoarthritis can be painful and cause disability for patients. Total joint replacement of the TMC joint provides a pseudo arthrosis with good restoration of the thumb motion and pain relief in most patients. But there is also a risk of no improvement following the operation. The purpose of this study was to identify patients at risk of no clinically important improvement following operative treatment of osteoarthritis of the TMC joint. METHODS: We included 287 consecutive patients (225 women, 62 men) treated with total joint replacement of the TMC joint due to osteoarthritis with a mean age of 58.9 years (range 41-80) in a prospective cohort study. We collected information preoperatively and 12 months postoperatively on disabilities of the arm, shoulder and hand score (DASH), grip strength and pain at rest and activity on a visual analogue scale (VAS). RESULTS: We found a statistically significant improvement in DASH from 42.0 to 15.9 (p < 0.001), VAS at rest from 3.5 to 0.6 (p < 0.001), VAS at activity from 7.9 to 2.5 (p < 0.001) and grip strength from 21.6 kg to 27.6 kg (p < 0.001) 12 months after the operation, when analysed as a group. There was an increased risk of no clinically important improvement in hand function for patients with preoperative high preoperative grip strength. Also, we found an increased risk of no clinically important improvement in female patients when using VAS as outcome. CONCLUSION: However, we were unable to detect one isolated preoperative predictor as indicator of successful result after operative treatment of TMC osteoarthritis, and as so it was not possible to establish a clinical valid tool for patient selection before surgery. Informed consent was obtained from all patients for being included in the study. The study needed no approval from The Regional Committee of Biomedical Research Ethics as the data was collected, as part of our normal pre- and postoperative clinical pathway, but the study is part of an outcome study of the results after total joint arthroplasty (TJA) of the TMC joint registered in Clinicaltrials.gov (NCT01554748). TRIAL REGISTRATION: Clinicaltrials.gov (NCT01554748). Registered 15 March 2012.",
keywords = "Functionality, Osteoarthritis, Postoperative improvement, Risk factors, Total joint replacement, Trapeziometacarpal joint, FOLLOW-UP, REGIONAL PAIN SYNDROME, TENDON INTERPOSITION, SURGICAL-TREATMENT, TRAPEZIECTOMY, LIGAMENT RECONSTRUCTION, SYNDROME TYPE-I, OUTCOMES, OSTEOARTHRITIS, MINIMAL IMPORTANT CHANGES",
author = "Mosegaard, {Sebastian Breddam} and Maiken Stilling and Hansen, {Torben B{\ae}k}",
year = "2020",
month = mar,
day = "30",
doi = "10.1186/s12955-020-01333-z",
language = "English",
volume = "18",
journal = "Health and Quality of Life Outcomes",
issn = "1477-7525",
publisher = "BioMed Central",
number = "1",

}

RIS

TY - JOUR

T1 - Risk factors for limited improvement after total trapeziometacarpal joint arthroplasty

AU - Mosegaard, Sebastian Breddam

AU - Stilling, Maiken

AU - Hansen, Torben Bæk

PY - 2020/3/30

Y1 - 2020/3/30

N2 - BACKGROUND: Trapeziometacarpal (TMC) osteoarthritis can be painful and cause disability for patients. Total joint replacement of the TMC joint provides a pseudo arthrosis with good restoration of the thumb motion and pain relief in most patients. But there is also a risk of no improvement following the operation. The purpose of this study was to identify patients at risk of no clinically important improvement following operative treatment of osteoarthritis of the TMC joint. METHODS: We included 287 consecutive patients (225 women, 62 men) treated with total joint replacement of the TMC joint due to osteoarthritis with a mean age of 58.9 years (range 41-80) in a prospective cohort study. We collected information preoperatively and 12 months postoperatively on disabilities of the arm, shoulder and hand score (DASH), grip strength and pain at rest and activity on a visual analogue scale (VAS). RESULTS: We found a statistically significant improvement in DASH from 42.0 to 15.9 (p < 0.001), VAS at rest from 3.5 to 0.6 (p < 0.001), VAS at activity from 7.9 to 2.5 (p < 0.001) and grip strength from 21.6 kg to 27.6 kg (p < 0.001) 12 months after the operation, when analysed as a group. There was an increased risk of no clinically important improvement in hand function for patients with preoperative high preoperative grip strength. Also, we found an increased risk of no clinically important improvement in female patients when using VAS as outcome. CONCLUSION: However, we were unable to detect one isolated preoperative predictor as indicator of successful result after operative treatment of TMC osteoarthritis, and as so it was not possible to establish a clinical valid tool for patient selection before surgery. Informed consent was obtained from all patients for being included in the study. The study needed no approval from The Regional Committee of Biomedical Research Ethics as the data was collected, as part of our normal pre- and postoperative clinical pathway, but the study is part of an outcome study of the results after total joint arthroplasty (TJA) of the TMC joint registered in Clinicaltrials.gov (NCT01554748). TRIAL REGISTRATION: Clinicaltrials.gov (NCT01554748). Registered 15 March 2012.

AB - BACKGROUND: Trapeziometacarpal (TMC) osteoarthritis can be painful and cause disability for patients. Total joint replacement of the TMC joint provides a pseudo arthrosis with good restoration of the thumb motion and pain relief in most patients. But there is also a risk of no improvement following the operation. The purpose of this study was to identify patients at risk of no clinically important improvement following operative treatment of osteoarthritis of the TMC joint. METHODS: We included 287 consecutive patients (225 women, 62 men) treated with total joint replacement of the TMC joint due to osteoarthritis with a mean age of 58.9 years (range 41-80) in a prospective cohort study. We collected information preoperatively and 12 months postoperatively on disabilities of the arm, shoulder and hand score (DASH), grip strength and pain at rest and activity on a visual analogue scale (VAS). RESULTS: We found a statistically significant improvement in DASH from 42.0 to 15.9 (p < 0.001), VAS at rest from 3.5 to 0.6 (p < 0.001), VAS at activity from 7.9 to 2.5 (p < 0.001) and grip strength from 21.6 kg to 27.6 kg (p < 0.001) 12 months after the operation, when analysed as a group. There was an increased risk of no clinically important improvement in hand function for patients with preoperative high preoperative grip strength. Also, we found an increased risk of no clinically important improvement in female patients when using VAS as outcome. CONCLUSION: However, we were unable to detect one isolated preoperative predictor as indicator of successful result after operative treatment of TMC osteoarthritis, and as so it was not possible to establish a clinical valid tool for patient selection before surgery. Informed consent was obtained from all patients for being included in the study. The study needed no approval from The Regional Committee of Biomedical Research Ethics as the data was collected, as part of our normal pre- and postoperative clinical pathway, but the study is part of an outcome study of the results after total joint arthroplasty (TJA) of the TMC joint registered in Clinicaltrials.gov (NCT01554748). TRIAL REGISTRATION: Clinicaltrials.gov (NCT01554748). Registered 15 March 2012.

KW - Functionality

KW - Osteoarthritis

KW - Postoperative improvement

KW - Risk factors

KW - Total joint replacement

KW - Trapeziometacarpal joint

KW - FOLLOW-UP

KW - REGIONAL PAIN SYNDROME

KW - TENDON INTERPOSITION

KW - SURGICAL-TREATMENT

KW - TRAPEZIECTOMY

KW - LIGAMENT RECONSTRUCTION

KW - SYNDROME TYPE-I

KW - OUTCOMES

KW - OSTEOARTHRITIS

KW - MINIMAL IMPORTANT CHANGES

UR - http://www.scopus.com/inward/record.url?scp=85082791166&partnerID=8YFLogxK

U2 - 10.1186/s12955-020-01333-z

DO - 10.1186/s12955-020-01333-z

M3 - Journal article

C2 - 32228611

AN - SCOPUS:85082791166

VL - 18

JO - Health and Quality of Life Outcomes

JF - Health and Quality of Life Outcomes

SN - 1477-7525

IS - 1

M1 - 90

ER -