Equivalent PROMIS Scores after Nonoperative or Operative Treatment of Trapeziometacarpal Osteoarthritis

Document Type : RESEARCH PAPER

Authors

Orthopaedics, Johns Hopkins University School of Medicine, Baltimore, USA

Abstract

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) scores can quantify symptoms
and limitations after upper extremity surgery. Our objective was to determine how these scores compare amongst
patients with trapeziometacarpal osteoarthritis treated either nonoperatively or operatively.
Methods: In this retrospective comparative study, we compared PROMIS scores (upper extremity function [UEF],
pain interference, and depression) between 43 patients who underwent nonoperative treatment (nonsteroidal antiinflammatory
drugs/splinting/injections) and 33 patients who underwent trapeziectomy with ligament reconstruction
and tendon interposition for trapeziometacarpal osteoarthritis (minimum 6-month recovery period) by 4 surgeons from
2014–2018. PROMIS scores were compared across all patients by Eaton-Littler staging. We used linear regression to
assess correlations between time-since-surgery and each PROMIS domain. Multivariable linear regression was used
to identify patient and disease factors independently associated with PROMIS scores.
Results: Surgery was not associated with better UEF (37 vs. 40, P=0.23), less pain interference (58 vs. 56, P=0.42),
or fewer symptoms of depression (47 vs. 46, P=0.59). Similarly, no differences were observed across all patient by
Eaton-Littler stage for UEF (P=0.49), pain (P=0.48), or depression (P=0.90). For the operative group, greater timesince-
surgery, or patient recovery period, correlated moderately with worse UEF (R=0.41) and increased pain (R=0.37).
Conclusion: In small retrospective comparative cohorts, surgery was not associated with better UEF, pain, or
depression scores compared with nonoperative treatment for trapeziometacarpal osteoarthritis.
Level of evidence: III

Keywords

References

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22(6):689-94.
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Treatment of basal joint arthritis of the thumb:
trapeziectomy with or without tendon interposition/
ligament reconstruction. Hand Surg. 2004; 9(1):5-9.
17. Gangopadhyay S, McKenna H, Burke FD, Davis
TR. Five- to 18-year follow-up for treatment of
trapeziometacarpal osteoarthritis: a prospective
comparison of excision, tendon interposition, and
ligament reconstruction and tendon interposition. J
Hand Surg Am. 2012; 37(3):411-7.
18. Wajon A, Vinycomb T, Carr E, Edmunds I, Ada L. Surgery
for thumb (trapeziometacarpal joint) osteoarthritis.
Cochrane Database Syst Rev. 2015; 2(1):CD004631.
19. Bernstein DN, Houck JR, Gonzalez RM, Wilbur DM,
Miller RJ, Mitten DJ, et al. Preoperative PROMIS scores
predict postoperative PROMIS score improvement for
patients undergoing hand surgery. Hand (N Y). 2020;
15(2):185-93.
20. Kennedy CD, Manske MC, Huang JI. Classifications
in brief: the eaton-littler classification of thumb
carpometacarpal joint arthrosis. Clin Orthop Relat
Res. 2016; 474(12):2729-33.
21. Berger AJ, Momeni A, Ladd AL. Intra- and
interobserver reliability of the Eaton classification
for trapeziometacarpal arthritis: a systematic review.
Clin Orthop Relat Res. 2014; 472(4):1155-9.
22. Crijns TJ, Bernstein DN, Ring D, Gonzalez RM, Wilbur
D, Hammert WC. Depression and pain interference
correlate with physical function in patients recovering
from hand surgery. Hand (N Y). 2019; 14(6):830-5.
23. Kazmers NH, Hung M, Rane AA, Bounsanga J, Weng
C, Tyser AR. Association of physical function, anxiety,
and pain interference in nonshoulder upper extremity
patients using the PROMIS platform. J Hand Surg Am.
2017; 42(10):781-7.
24. 24- Talaei-Khoei M, Fischerauer SF, Jha R, Ring D,
Chen N, Vranceanu AM. Bidirectional mediation of
depression and pain intensity on their associations
with upper extremity physical function. J Behav Med.
2018; 41(3):309-17.
25. Ehrl D, Erne HC, Broer PN, Metz C, Falter E. Outcomes of
denervation, joint lavage and capsular imbrication for
painful thumb carpometacarpal joint osteoarthritis. J
Hand Surg Eur Vol. 2016; 41(9):904-9.
26. Tuffaha SH, Quan A, Hashemi S, Parikh P, O’Brien-Coon
DM, Broyles JM, et al. Selective thumb carpometacarpal
joint denervation for painful arthritis: clinical
outcomes and cadaveric study. J Hand Surg Am. 2018;
44(1):64.e1-8.
27. Giesen T, Klein HJ, Franchi A, Medina JA, Elliot D.
Thumb carpometacarpal joint denervation for
primary osteoarthritis: a prospective study of 31
thumbs. Hand Surg Rehabil. 2017; 36(3):192-7.
28. Beleckas CM, Padovano A, Guattery J, Chamberlain AM,
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The Archives of Bone and Joint Surgery
Volume 8, Issue 3
May 2020
Pages 383-390

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History

  • Receive Date: 13 July 2019
  • Revise Date: 12 September 2019
  • Accept Date: 18 September 2019

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