Abstract
Background Results following carpometacarpal (CMC) arthrodesis of the thumb for osteoarthritis
vary widely in literature. Data on long-term patient-reported outcome measurements
(PROMs) after thumb CMC joint arthrodesis for osteoarthritis are scarce.
Purpose We report the long-term outcomes of PROMs (function, pain, and satisfaction) after
arthrodesis of the thumb CMC joint. We evaluated the correlation of function and pain
with patient satisfaction.
Methods Long-term PROMs after thumb CMC arthrodesis for osteoarthritis were evaluated using
a retrospective cohort (1996–2015). Three different PROM questionnaires (Disabilities
of the Arm, Shoulder, and Hand Questionnaire, Dutch Language version [DASH-DLV], the
Patient-Related Wrist and Hand Questionnaire Dutch Language version [PRWHE-DLV], and
a questionnaire concerning satisfaction) were sent to all patients.
Results Twenty-five arthrodeses (21 patients) were available for long-term follow-up. The
median follow-up time was 10.8 years (interquartile range [IQR]: 9.7–13.0). The median
DASH score was 29.2 (IQR: 14.4–38.3), median PRWHE score was 25.0 (IQR: 12.5–44.3).
The median satisfaction after the operation and satisfaction with outcome of the operation
was 10 for both (on a Likert's scale with 1 worse and 10 excellent satisfaction).
There was a statistically significant correlation between the PRWHE total score and
PRWHE pain score and satisfaction with surgery and satisfaction with the result. There
was no correlation between PRWHE function score and satisfaction or DASH and satisfaction.
Results after hardware removal showed no significant differences compared with patients
without hardware removal.
Conclusion Patients who underwent arthrodesis for thumb CMC osteoarthritis showed high satisfaction
at long-term follow-up, despite moderate results as measured using the DASH and PRWHE.
The PRWHE total and PRWHE pain scores correlated significantly with satisfaction with
surgery and satisfaction with the result, respectively, whereas no correlation was
observed with the PRWHE function score or DASH and satisfaction. This therapeutic
study reflects level of evidence IV.
Keywords
arthrodesis - carpometacarpal osteoarthritis - basal thumb joint - patient-reported
outcome measurements
