Osteoarthrosis of the Carpometacarpal Joint of the Thumb
Conditions
Keywords
Carpometacarpal arthritis, Basal joint arthritis, CMC arthritis, Osteoarthritis
Brief summary
The data in this prospective registry will be used 1) to define which surgical and nonoperative techniques are most effective at providing pain relief, restoring function, are cost effective, and patients are satisfied with their outcomes; and 2) to design focused clinical questions regarding the optimal treatment of basal joint arthritis of the thumb in future randomized controlled trials. There are no interventions or changes in patient care associated with this study.
Detailed description
Basal joint arthritis of the thumb is a common condition associated with considerable morbidity. Many non-operative and operative treatments have been described but few multi-center prospective evidence based trials comparing standard treatments have been done. This continuing search for consensus of best clinical practices has been reviewed in a thorough meta-analysis of operative treatments for basal joint arthritis. Through the systematic collection of data regarding patient-specific characteristics, treatment interventions, and longitudinal functional outcome measurements the investigators believe patient outcomes and satisfaction can improve through the elucidation of risk factors for disease progression, and the timing and selection of treatment modalities, either conservative or surgical, for any particular patient. The establishment of a multi-center clinical registry will greatly facilitate these goals. The study hypothesizes that there exist effective non-operative and operative treatments for certain patient populations with basal joint arthritis of the thumb. There also exists a functionally superior, cost effective, and low risk non-operative or minimally invasive operative treatment regime to alleviate pain and slow the progression of disease in those with less advanced disease. Likewise, there is significant functional, health utility, and economic advantage to surgically treating advanced basal joint arthritis with one of the popularized procedures currently in practice.
Interventions
None listed
Sponsors
Columbia University
Orthopedic Research and Education Foundation
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who have symptomatic basal joint arthritis. * Patients who are capable of providing informed consent.
Exclusion criteria
* Patients younger than 18 years old at the time of enrollment. * Patients with neuromuscular disease affecting the operated hand, not caused by the CMC operation. * Patients with known inflammatory arthritic conditions, such as rheumatoid or psoriatic arthritis. * Patients with a history of or current infection of the basal joint of the affected hand. * Patients who are demented or are unable to provide informed consent. * Patients unable to comply with study guidelines. * Patients who have metacarpophalangeal joint hyperextension are NOT excluded. These patients will be followed and if they receive a capsulodesis or other procedure at the MCPJ at the same time as their basal joint arthroplasty this will be noted in their data records.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Flexion/extension range of MCP joint | Baseline, 6 weeks, 3 months, 6 months, 1 year | Range of motion measured in degrees of the metacarpophalangeal (MCP) joint. |
| Flexion/extension range of IP joint | Baseline, 6 weeks, 3 months, 6 months, 1 year | Range of motion measured in degrees of the interphalangeal (IP) joint. |
| Grip strength | Baseline, 6 weeks, 3 months, 6 months, 1 year | This will be quantified with use of a Jamar dynamometer set in the second position. |
| Key-pinch strength | Baseline, 6 weeks, 3 months, 6 months, 1 year | A 30-lb pinch dynamometer will used to determine lateral key-pinch strength. |
| Tip-pinch strength | Baseline, 6 weeks, 3 months, 6 months, 1 year | A 30-lb pinch dynamometer will used to determine lateral tip-pinch strength. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Average total costs per patient | Up to 1 year | Review or estimation of hospital and office bills including those for the prescribed therapy and/or splinting will be tallied for each patient. |
| Disability of Arm, Shoulder and Hand (DASH) score | Baseline, 6 weeks, 3 months, 6 months, 1 year | A questionnaire designed to assess musculoskeletal disorders of the upper limbs. |
| SF-36 questionnaire score | Baseline, 6 weeks, 3 months, 6 months, 1 year | A questionnaire designed to validate general health: surveys physical functioning, performance in a physical role, performance in an emotional role, vitality, social functioning, bodily pain, general health perceptions, and mental health. |
| Prevalence of arthritis progression | Baseline, 6 weeks, 3 months, 6 months, 1 year | Radiographs will be performed classify each patient within the Eaton 102 osteoarthritis staging system. Sequential radiographs will be examined for progression of joint abnormalities. |
Countries
United States
Contacts
CONTACTMelvin P Rosenwasser, MD
PRINCIPAL_INVESTIGATORMelvin P Rosenwasser, MD
Columbia University
Outcome results
None listed