Equivalent PROMIS Scores after Nonoperative or Operative Treatment of Trapeziometacarpal Osteoarthritis

Document Type : RESEARCH PAPER


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


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