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DOS Kongressen 2017 ·
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IDENTIFICATION OF PREDICTORS FOR EFFECT OF OP-
ERATION FOR OSTEOARTHRITIS IN THE TRAPEZIO-
METACARPAL JOINT WITH A TOTAL JOINT REPLACE-
MENT
Sebastian BreddamMosegaard, Maiken Stilling, Torben Bæk Hansen, Eva Glassou
University Clinic for Hand, Hip and Knee Surgery, Department of Orthopaedics,
Holstebro Regional Hospital, Denmark
Background:
The potential effect from a hand operation as well as the poten-
tial risk is wide-ranging. An unsuccessful result after hand surgery will not only
affect the patient but could also lead to increased expenses for the community
(sick days) along with the potential loss of working capacity.
Purpose / Aim of Study:
To identify potential predictors of low effect of op-
eration for osteoarthritis in the trapeziometacarpal joint using total joint arthro-
plasty (TMTJA).
Materials and Methods:
The study includes 287 patients with a mean age of
58.8 years (range 41-80) treated with TMTJA. In bilateral patients only data
from the hand first treated was used. The patients were followed prospective-
ly with hand function (DASH), pain score at rest and activity (VAS) and grip
strength preoperatively and after 12 months. A positive outcome was defined
as: DASH improvement >19 point, VAS improvement >3, grip strength im-
provement >15%. A combined positive outcome was defined as: a combination
of at least 2 positive outcomes. Logistic regression was used to test for predic-
tors of a negative outcome.
Findings / Results:
There was no effect of age or sex. The probability of a
positive outcome depended on the preoperative scores in DASH, VAS and grip
strength. This means that if scores were already “good” prior to surgery a posi-
tive outcome was difficult to achieve. Preoperative grip strength was the only
outcome measure with significant effect on the combined positive outcome
(p<0.001). 55% had improvements in grip strength, 65% in DASH, 70% in VAS
and 70% in combined positive outcome.
Conclusions:
There was no isolated predictor for effect of operation with TM-
TJA. The probability of a positive effect was better with a preoperative high VAS,
high DASH and low grip strength.
No conflicts of interest reported
83.