Osteoarthritis
Conditions
Keywords
trapezotrapezoidial, scaphotrapezial, thumb, pain, orthoses, Osteoarthritis in the BTOA concerns the trapezometacarpal joint
Brief summary
The prevalence of digital osteoarthritis varies according to whether a radiological or clinical definition is adopted. Interventions: Thumb orthoses to be worn at night and usual care vs usual care. Outcome measures: Pain at 1 month assessed on visual analog scale is the main outcome measure. Disability at 6 months (Cochin Hand Function Scale) and deformation at 1 year are the main secondary outcome measures.
Detailed description
The prevalence of digital osteoarthritis varies according to whether a radiological or clinical definition is adopted. Radiologically defined osteoarthritis of the hand has been estimated to represent 38% of women and 24.5% of men over 66 years of age but higher prevalence of 60-70% has also been reported. Of patients with radiological signs, 20 to 40% become symptomatic. For patients over 55 years of age, the distal interphalangeal joints are the most prevalent site of osteoarthritis (20%) determined radiologically and clinically, followed by the base of the thumb (8%) and proximal interphalangeal joints (5%). This prevalence increases with age, and the incidence peaks in perimenopausal women. Osteoarthritis in the base of the thumb (BTOA) concerns the trapeziometacarpal joint, with a possible secondary location at the trapezotrapezoidial and scaphotrapezial joints. BTOA induces a closure of the first web, which in turn causes an alteration of the thumb-index pinch and therefore a limitation in hand function. Pain induced by the compression of the thumb column during pinching could also lead to functional disability. Effect of a simple intervention such as wearing rest thumb orthoses on pain and disability is unknown.
Interventions
DEVICEThumb orthoses
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Pain at the base of the thumb 30 mm on VAS * Patient aged 45 and \< 75 years old * At least 2 of the 5 items on the trapeziometacarpal joint radiograph osteophytes * joint space narrowing * subchondral bone sclerosis * subchondral cysts * At least 1 of the 2 clinical items trapeziometacarpal joint enlargement closure of the first web
Exclusion criteria
* Post traumatic osteoarthritis * Cristal arthropathy * Inflammatory arthritis * Neurologic disorder involving upper limb * Psychiatric disorder needing treatment adaptation in the last 3 months * Hand or wrist trauma within the last 2 months * Previous hand surgery * Unable to speak or write French * Pregnancy * Collagen diseases (Dupuytren, Marfan, Ehlers Danlos syndromes) * Hand or wrist infiltration within 2 months * Skin disease interfering with the wearing of the orthoses * Having already worn a BTOA orthoses * Having bilateral BTOA without predominant symptomatic side
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain at 1 month assessed on visual analog scale is the main outcome measure. | — |
Secondary
| Measure | Time frame |
|---|---|
| Disability at 6 months (Cochin Hand Function Scale) and deformation at 1 year are the main secondary outcome measures. | — |
Outcome results
None listed