Article Text

PDF
THU0726-HPR What characterises patients referred for surgical consultation due to carpometacarpal osteoarthritis?
  1. EMH Gravas1,
  2. R Nossum2,
  3. REM Eide3,
  4. A Klokkereide4,
  5. KH Matre3,
  6. M Olsen4,
  7. S Darre2,
  8. O Andreassen1,
  9. N Osteras1,
  10. I Kjeken1
  1. 1Diakonhjemmet Hospital, Oslo
  2. 2St.Olavs Hospital, Trondheim
  3. 3Haukeland University Hospital, Bergen
  4. 4Haugesund Rheumatism Hospital, Haugesund, Norway

Abstract

Background Carpometacarpal osteoarthritis (CMC-OA) is a common joint condition, with a prevalence of 13% in people aged 41 to 50 years, increasing to 68% in people between 71 and 80 years. In the absence of disease-modifying interventions, non-pharmacological approaches are considered as core treatments for hand OA, while surgery is recommended for those with severe CMC-OA.

Objectives To describe function and previous treatment in patients referred for surgical consultation due to CMC-OA.

Methods Individuals referred for surgical consultation due to their CMC-OA at three Norwegian departments of rheumatology were invited to participate. Those who agreed attended a clinical assessment and reported their symptoms, disability and function using validated outcome measures including the Quick-Dash (0–100, 0=no disability) and the MAPHand (1–4, 1=no limitations).

Results A total of 180 patients (mean age 63, range: 45 to 82; 79% women) were included. Thirty-six percent were referred for right hand, 43% for left hand, and 21% for bilateral surgery. Concerning previous treatment for hand OA, 21% (78% women) had received hand surgery, 22% (81% women) physical or occupational therapy, and 11% (95% women) had consulted a rheumatologist. Women consistently reported higher pain levels compared to men, had more finger joints with bony enlargements and significantly lower grip and pinch strength in both hands (Table). They also reported significantly more disability and activity limitations at Quick Dash; 38.6 versus 30.4, (p=0.006) and MAPHand; 2.0 versus 1.7 (p<0.001), for women and men, respectively. However, for finger range of motion, men had slightly more flexion deficit and less palmar abduction in their left hand compared to women.

Table 1.

Hand function

Conclusions Among patients referred for surgical consultation due to CMC-OA, women self-reported lower hand function and scored poorer than men in observer based assessments. Even if conservative treatment is recommended before referral for surgery, only a few participants had received such treatment for their hand OA.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.