PMID- 34881105
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220506
IS  - 2163-3916 (Print)
IS  - 2163-3924 (Electronic)
IS  - 2163-3916 (Linking)
VI  - 10
IP  - 6
DP  - 2021 Dec
TI  - Joint Distraction for Thumb Carpometacarpal Osteoarthritis: 2-Year Follow-up 
      Results of 20 Patients.
PG  - 502-510
LID - 10.1055/s-0041-1728806 [doi]
AB  - Background  Joint distraction is a fairly new treatment for patients with 
      symptomatic thumb carpometacarpal osteoarthritis (CMC1 OA). A previous pilot 
      study of five patients showed that CMC1 joint distraction is technically 
      feasible. The current study presents the results of CMC1 joint distraction in 20 
      patients with a 2-year follow-up period. Purposes  The primary study aim was to 
      assess if patients with CMC1 OA have better physical function and less pain 2 
      years after CMC1 joint distraction. Second, we assessed the number of patients 
      who achieved a minimal clinically important difference (MCID) in patient-reported 
      outcome measures at each follow-up time point. Furthermore, this study sought 
      differences on magnetic resonance imaging (MRI) of the CMC1 joint before and 
      after distraction. Adverse events were noted and reported. Methods  Twenty 
      patients (median age of 54 years) with symptomatic CMC1 OA and an established 
      indication for a trapeziectomy were enrolled. An external distractor device was 
      placed over the CMC1 joint and left in situ for 8 weeks. Disabilities of the Arm, 
      Shoulder, and Hand (DASH) score, Michigan Hand Outcome Questionnaire (MHQ), 
      visual analogue scale (VAS), and grip strength were recorded preoperatively and 
      at 3, 6, 12, and 24 months postoperatively. Results  Two years after joint 
      distraction, physical function and pain scores had improved significantly 
      compared with baseline: DASH from 48 to 17, MHQ from 56 to 83, and VAS for pain 
      from 50 to 18 mm. Fourteen of 19 patients (74%) reached an MCID in DASH and MHQ 
      scores. One patient was not satisfied with treatment outcome and chose to proceed 
      with a trapeziectomy 14 months after initial distraction therapy. Conclusions 
       This study demonstrates that CMC1 joint distraction can postpone more invasive 
      surgical interventions (e.g., trapeziectomy) for at least 2 years. Larger 
      comparative studies are needed to assess the value of CMC1 joint distraction in 
      the treatment of CMC1 OA. Level of Evidence  This is a Level IV, prospective case 
      series study.
CI  - Thieme. All rights reserved.
FAU - Ottenhoff, Janna S E
AU  - Ottenhoff JSE
AUID- ORCID: 0000-0002-0359-0654
AD  - Department of Plastic, Reconstructive and Hand Surgery, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
FAU - Spaans, Anne J
AU  - Spaans AJ
AUID- ORCID: 0000-0002-4959-4562
AD  - Department of Orthopedic Surgery, Sint Maartenskliniek, Ubbergen, The 
      Netherlands.
FAU - Braakenburg, Assa
AU  - Braakenburg A
AUID- ORCID: 0000-0002-7472-009X
AD  - Department of Plastic, Reconstructive and Hand Surgery, St. Antonius Hospital, 
      Nieuwegein, The Netherlands.
FAU - Teunis, Teun
AU  - Teunis T
AUID- ORCID: 0000-0001-5660-0695
AD  - Department of Plastic, Reconstructive and Hand Surgery, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
FAU - van Minnen, L Paul
AU  - van Minnen LP
AUID- ORCID: 0000-0001-6421-5631
AD  - Department of Plastic Surgery, Royal Adelaide Hospital, Adelaide, Australia.
FAU - Mink van der Molen, Aebele B
AU  - Mink van der Molen AB
AUID- ORCID: 0000-0002-9747-4370
AD  - Department of Plastic, Reconstructive and Hand Surgery, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
AD  - Department of Orthopedic Surgery, St. Antonius Hospital, Nieuwegein, The 
      Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20210504
PL  - United States
TA  - J Wrist Surg
JT  - Journal of wrist surgery
JID - 101603430
PMC - PMC8635830
OTO - NOTNLM
OT  - carpometacarpal joint
OT  - external fixator
OT  - osteoarthritis
OT  - thumb
OT  - treatment
COIS- Conflict of Interest T.T. has or may have receive payment or benefits from AO 
      Trauma, DePuy Synthes, and PATIENT + , outside the submitted work. J.S.E.O., 
      A.J.S., A.B., L.P.v.M., and A.B.M.v.d.M. certify that they have no commercial 
      associations (e.g., consultancies, stock ownership, equity interest, 
      patent/licensing arrangements, etc.) that might pose a conflict of interest in 
      connection with the submitted article.
EDAT- 2021/12/10 06:00
MHDA- 2021/12/10 06:01
PMCR- 2022/05/04
CRDT- 2021/12/09 07:03
PHST- 2020/10/30 00:00 [received]
PHST- 2021/03/10 00:00 [accepted]
PHST- 2021/12/09 07:03 [entrez]
PHST- 2021/12/10 06:00 [pubmed]
PHST- 2021/12/10 06:01 [medline]
PHST- 2022/05/04 00:00 [pmc-release]
AID - 2000152cra [pii]
AID - 10.1055/s-0041-1728806 [doi]
PST - epublish
SO  - J Wrist Surg. 2021 May 4;10(6):502-510. doi: 10.1055/s-0041-1728806. eCollection 
      2021 Dec.