Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function

Purpose: This study aimed to assess how much symptoms resolve during a 6-week continued nonsurgical treatment with an orthosis and after trapeziectomy in people with thumb carpometacarpal joint osteoarthritis (CMC-1 OA) referred for surgical consultation. The data on symptom resolution magnitude and...

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Main Authors: Kati Jaatinen, M.Sc, Jenni Pajari, MD, Eero Waris, MD, PhD, Jarkko Jokihaara, MD, PhD, Simo Taimela, MD, PhD, Teppo L.N. Järvinen, MD, PhD, Teemu Karjalainen, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-11-01
Series:Journal of Hand Surgery Global Online
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589514125000611
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author Kati Jaatinen, M.Sc
Jenni Pajari, MD
Eero Waris, MD, PhD
Jarkko Jokihaara, MD, PhD
Simo Taimela, MD, PhD
Teppo L.N. Järvinen, MD, PhD
Teemu Karjalainen, MD, PhD
author_facet Kati Jaatinen, M.Sc
Jenni Pajari, MD
Eero Waris, MD, PhD
Jarkko Jokihaara, MD, PhD
Simo Taimela, MD, PhD
Teppo L.N. Järvinen, MD, PhD
Teemu Karjalainen, MD, PhD
author_sort Kati Jaatinen, M.Sc
collection DOAJ
description Purpose: This study aimed to assess how much symptoms resolve during a 6-week continued nonsurgical treatment with an orthosis and after trapeziectomy in people with thumb carpometacarpal joint osteoarthritis (CMC-1 OA) referred for surgical consultation. The data on symptom resolution magnitude and trajectory can help inform patients about postsurgical recovery and assist researchers in designing clinical trials to evaluate surgery’s effectiveness for CMC-1 OA. Methods: We recruited 52 patients with CMC-1 OA referred for surgical consultation. All eligible and willing patients underwent a 6-week treatment period with an orthosis before trapeziectomy. We collected outcome measures at the time of recruitment, after 6-week use of an orthosis (time of surgery), and at 3, 6, 9, and 12 months following the surgery. The Patient-Rated Wrist/Hand Evaluation questionnaire was the primary outcome measure. We used a repeated measures mixed model to estimate the group mean values for continuous outcomes. We compared the estimates with known minimal clinically important difference values. Results: A continued nonsurgical treatment with a 6-week use of an orthosis resulted in no relief from hand disability and pain. After trapeziectomy, a large and clinically important change occurred at 3 months, and a rapid decrease in symptoms continued until 6 months, at which point it was three times the minimal clinically important difference value for Patient-Rated Wrist/Hand Evaluation. Conclusions: This study provides useful estimates for the trajectory and magnitude of the symptom resolution after trapeziectomy. A continued nonsurgical treatment with a 6-week use of an orthosis had a negligible impact on symptoms in patients who were referred for surgical consultation. In contrast, a large improvement can be expected after trapeziectomy. However, it remains unclear how much of this change is attributable to the surgery itself. Type of study/level of evidence: Therapeutic IIb.
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spelling doaj-art-be1f51217fcf4271aece7e2e73f033682025-08-23T04:48:54ZengElsevierJournal of Hand Surgery Global Online2589-51412025-11-017610074110.1016/j.jhsg.2025.100741Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and FunctionKati Jaatinen, M.Sc0Jenni Pajari, MD1Eero Waris, MD, PhD2Jarkko Jokihaara, MD, PhD3Simo Taimela, MD, PhD4Teppo L.N. Järvinen, MD, PhD5Teemu Karjalainen, MD, PhD6Hospital Nova of Central Finland, Wellbeing Services County of Central Finland, Jyväskylä, Finland; Finnish Centre of Evidence-Based Orthopaedics (FICEBO), Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Meilahti Bridge Hospital, Helsinki, FinlandDepartment of Hand Surgery, Tyks Orto Surgical Hospital, Turku University Hospital, Turku, FinlandDepartment of Hand Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Mehiläinen Helsinki Hospital, Helsinki, FinlandDivision of Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandFinnish Centre of Evidence-Based Orthopaedics (FICEBO), Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Meilahti Bridge Hospital, Helsinki, FinlandFinnish Centre of Evidence-Based Orthopaedics (FICEBO), Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Meilahti Bridge Hospital, Helsinki, FinlandHospital Nova of Central Finland, Wellbeing Services County of Central Finland, Jyväskylä, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Corresponding author: Teemu Karjalainen, MD, PhD, Faculty of Medicine and Health Technology, Tampere University, Kalevantie 4, Tampere 33100, Finland.Purpose: This study aimed to assess how much symptoms resolve during a 6-week continued nonsurgical treatment with an orthosis and after trapeziectomy in people with thumb carpometacarpal joint osteoarthritis (CMC-1 OA) referred for surgical consultation. The data on symptom resolution magnitude and trajectory can help inform patients about postsurgical recovery and assist researchers in designing clinical trials to evaluate surgery’s effectiveness for CMC-1 OA. Methods: We recruited 52 patients with CMC-1 OA referred for surgical consultation. All eligible and willing patients underwent a 6-week treatment period with an orthosis before trapeziectomy. We collected outcome measures at the time of recruitment, after 6-week use of an orthosis (time of surgery), and at 3, 6, 9, and 12 months following the surgery. The Patient-Rated Wrist/Hand Evaluation questionnaire was the primary outcome measure. We used a repeated measures mixed model to estimate the group mean values for continuous outcomes. We compared the estimates with known minimal clinically important difference values. Results: A continued nonsurgical treatment with a 6-week use of an orthosis resulted in no relief from hand disability and pain. After trapeziectomy, a large and clinically important change occurred at 3 months, and a rapid decrease in symptoms continued until 6 months, at which point it was three times the minimal clinically important difference value for Patient-Rated Wrist/Hand Evaluation. Conclusions: This study provides useful estimates for the trajectory and magnitude of the symptom resolution after trapeziectomy. A continued nonsurgical treatment with a 6-week use of an orthosis had a negligible impact on symptoms in patients who were referred for surgical consultation. In contrast, a large improvement can be expected after trapeziectomy. However, it remains unclear how much of this change is attributable to the surgery itself. Type of study/level of evidence: Therapeutic IIb.http://www.sciencedirect.com/science/article/pii/S2589514125000611Carpometacarpal jointOrthosisOsteoarthritisThumbTrapeziectomy
spellingShingle Kati Jaatinen, M.Sc
Jenni Pajari, MD
Eero Waris, MD, PhD
Jarkko Jokihaara, MD, PhD
Simo Taimela, MD, PhD
Teppo L.N. Järvinen, MD, PhD
Teemu Karjalainen, MD, PhD
Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function
Journal of Hand Surgery Global Online
Carpometacarpal joint
Orthosis
Osteoarthritis
Thumb
Trapeziectomy
title Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function
title_full Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function
title_fullStr Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function
title_full_unstemmed Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function
title_short Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function
title_sort orthosis followed by trapeziectomy for thumb base osteoarthritis a cohort pilot study on pain and function
topic Carpometacarpal joint
Orthosis
Osteoarthritis
Thumb
Trapeziectomy
url http://www.sciencedirect.com/science/article/pii/S2589514125000611
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