Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational study

Abstract Background In rhizarthrosis the saddle joint of the thumb is affected. Occupational therapy after interposition arthroplasty is of particular importance and a key factor for a successful outcome. Orthosis use and/or the timeline of using the orthosis is still under debate. Research question...

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Main Authors: Christian Krasny, Melanie Auerbach, Christian Radda, Daniel Schallmayer, Gudrun H. Borchert, Barbara Frauscher, Manuela Rampetsreiter, Christian Albrecht, Christian Wurnig
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08433-1
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author Christian Krasny
Melanie Auerbach
Christian Radda
Daniel Schallmayer
Gudrun H. Borchert
Barbara Frauscher
Manuela Rampetsreiter
Christian Albrecht
Christian Wurnig
author_facet Christian Krasny
Melanie Auerbach
Christian Radda
Daniel Schallmayer
Gudrun H. Borchert
Barbara Frauscher
Manuela Rampetsreiter
Christian Albrecht
Christian Wurnig
author_sort Christian Krasny
collection DOAJ
description Abstract Background In rhizarthrosis the saddle joint of the thumb is affected. Occupational therapy after interposition arthroplasty is of particular importance and a key factor for a successful outcome. Orthosis use and/or the timeline of using the orthosis is still under debate. Research questions: In patients with rhizarthrosis after interposition arthroplasty, what is the effect of an orthotic thumb device compared with no orthotic thumb device during accompanying occupational therapy? In patients with rhizarthrosis after interposition arthroplasty, what is the effect of a long orthotic thumb device compared with a short orthotic thumb device during accompanying occupational therapy? Methods Forty-two patients with confirmed symptomatic rhizarthrosis after interposition arthroplasty by Weilby and 2 weeks cast fixation were randomly assigned to one of the following study arms: Group I: long orthotic thumb device, Group II: short orthotic thumb device, Group III without orthotic thumb device for 4 weeks, accompanied by 12 weeks postoperative occupational therapy. After 6 and 12 weeks, VAS-Pain-Score, Quick-DASH, pinch-and grip-strength, and ROM were evaluated. Results All groups improved in their hand functions 12 weeks after surgery. The VAS-pain-score improved by 5 points. The Quick-DASH score halved for patients with short or no orthotic thumb device. Patients with the short orthotic thumb device showed the highest rate of improvement (pain, QuickDASH, mobility of the carpometacarpal joint in abduction, interphalangeal joint mobility, and thumb function) 12 weeks after surgery, followed by the non-orthotic thumb device-group. Non-orthotic thumb device patients did not show higher pain levels. Patients of the long orthotic thumb device-group showed more impairment of their function (pain, grip- and pinch strength compared to the other groups, 12 weeks after surgery). Conclusion After interposition arthroplasty of the thumb followed by two weeks cast fixation, a thermoplastic short orthotic thumb device should be used. The short orthotic thumb device only restricts motion of the operated first carpometacarpal joint, leaving all other joints of the thumb moveable for 4 weeks. This recommendation is based on the results obtained 12 weeks after surgery. Trial registration Not applicable because this is the publication following a thesis in Austria. At the time of the start of the study, there was no need for registration for such studies in Austria.
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spelling doaj-art-63b0907bc20e4bed9e45b9452aadfca92025-08-20T03:06:00ZengBMCBMC Musculoskeletal Disorders1471-24742025-03-0126111010.1186/s12891-025-08433-1Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational studyChristian Krasny0Melanie Auerbach1Christian Radda2Daniel Schallmayer3Gudrun H. Borchert4Barbara Frauscher5Manuela Rampetsreiter6Christian Albrecht7Christian Wurnig8First Orthopedic Devision, Orthopädisches Spital SpeisingFirst Orthopedic Devision, Orthopädisches Spital SpeisingFirst Orthopedic Devision, Orthopädisches Spital SpeisingFirst Orthopedic Devision, Orthopädisches Spital SpeisingDr. Borchert Medical Information ManagementDepartment of Physiotherapy and Rehabilitation, Orthopädisches Spital SpeisingDepartment of Physiotherapy and Rehabilitation, Orthopädisches Spital SpeisingFirst Orthopedic Devision, Orthopädisches Spital SpeisingFirst Orthopedic Devision, Orthopädisches Spital SpeisingAbstract Background In rhizarthrosis the saddle joint of the thumb is affected. Occupational therapy after interposition arthroplasty is of particular importance and a key factor for a successful outcome. Orthosis use and/or the timeline of using the orthosis is still under debate. Research questions: In patients with rhizarthrosis after interposition arthroplasty, what is the effect of an orthotic thumb device compared with no orthotic thumb device during accompanying occupational therapy? In patients with rhizarthrosis after interposition arthroplasty, what is the effect of a long orthotic thumb device compared with a short orthotic thumb device during accompanying occupational therapy? Methods Forty-two patients with confirmed symptomatic rhizarthrosis after interposition arthroplasty by Weilby and 2 weeks cast fixation were randomly assigned to one of the following study arms: Group I: long orthotic thumb device, Group II: short orthotic thumb device, Group III without orthotic thumb device for 4 weeks, accompanied by 12 weeks postoperative occupational therapy. After 6 and 12 weeks, VAS-Pain-Score, Quick-DASH, pinch-and grip-strength, and ROM were evaluated. Results All groups improved in their hand functions 12 weeks after surgery. The VAS-pain-score improved by 5 points. The Quick-DASH score halved for patients with short or no orthotic thumb device. Patients with the short orthotic thumb device showed the highest rate of improvement (pain, QuickDASH, mobility of the carpometacarpal joint in abduction, interphalangeal joint mobility, and thumb function) 12 weeks after surgery, followed by the non-orthotic thumb device-group. Non-orthotic thumb device patients did not show higher pain levels. Patients of the long orthotic thumb device-group showed more impairment of their function (pain, grip- and pinch strength compared to the other groups, 12 weeks after surgery). Conclusion After interposition arthroplasty of the thumb followed by two weeks cast fixation, a thermoplastic short orthotic thumb device should be used. The short orthotic thumb device only restricts motion of the operated first carpometacarpal joint, leaving all other joints of the thumb moveable for 4 weeks. This recommendation is based on the results obtained 12 weeks after surgery. Trial registration Not applicable because this is the publication following a thesis in Austria. At the time of the start of the study, there was no need for registration for such studies in Austria.https://doi.org/10.1186/s12891-025-08433-1Thumb interposition arthroplastyOrthosisVAS painGrip-and pinch strengthQuick-DASHROM
spellingShingle Christian Krasny
Melanie Auerbach
Christian Radda
Daniel Schallmayer
Gudrun H. Borchert
Barbara Frauscher
Manuela Rampetsreiter
Christian Albrecht
Christian Wurnig
Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational study
BMC Musculoskeletal Disorders
Thumb interposition arthroplasty
Orthosis
VAS pain
Grip-and pinch strength
Quick-DASH
ROM
title Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational study
title_full Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational study
title_fullStr Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational study
title_full_unstemmed Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational study
title_short Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb, an observational study
title_sort comparison of three different postoperative treatment options after interposition arthroplasty of the thumb an observational study
topic Thumb interposition arthroplasty
Orthosis
VAS pain
Grip-and pinch strength
Quick-DASH
ROM
url https://doi.org/10.1186/s12891-025-08433-1
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