Patients Report Positive Outcomes for Nonsurgical Treatment of Thumb OA

THURSDAY, Nov. 30, 2023 (HealthDay News) -- At five years, patients report positive outcomes for nonsurgical treatment of thumb carpometacarpal (CMC-1) osteoarthritis (OA), according to a study published online Oct. 30 in the  Journal of Bone & Joint Surgery.

Lisa M. J. Esteban Lopez, from Erasmus Medical Center in Rotterdam, Netherlands, and colleagues investigated patient-reported pain and limitations in activities of daily living (ADL) at a median 6.6 years following nonsurgical treatment (i.e., exercise therapy and use of an orthosis) for CMC-1 OA. The analysis included 217 survey respondents.

The researchers found that at a median 6.6 years, the score on the Michigan Hand Outcomes Questionnaire (MHQ) pain subscale did not differ significantly from that seen at 12 months. There was improvement in MHQ ADL scores of 4.4 points versus that seen at 12 months, but this finding was not clinically relevant. At five or more years, 5 percent of the patients rated their satisfaction as "poor," 14 percent as "moderate," 26 percent as "fair," 39 percent as "good," and 16 percent as "excellent." For the EuroQol-5 Dimensions-5 Levels index, the median score was 0.852 (range, 0.135 to 1). Twenty-two percent of patients converted to surgery at a median follow-up of seven years.

“Our findings support nonsurgical treatment as the first treatment choice and suggest that treatment effects are sustainable," the authors write.

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