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In
people with first carpometacarpal osteoarthritis, early mobilization is as
effective and safe as a more restrictive regimen.
According to the findings of a prospective, noninferiority, randomized controlled trial published in The Journal of Hand Surgery, a postsurgery regimen with early mobilization after trapeziectomy has comparable efficacy and safety as a more restrictive postsurgery regimen with longer immobilization (rigid orthosis and mobilization after six weeks) in osteoarthritis people scheduled for first carpometacarpal (CMC) joint surgery.
Investigators aimed to compare two postoperative therapy regimens in people suffering from osteoarthritis of the first CMC joint. The study recruited 59 participants (88% women, mean age 65 years) and randomized them to either the intervention group (Early mobilization, n=29) or the control group (Usual postoperative care, n=29). Assessment of the recruited subjects was carried out at baseline (prior to group segregation) and at three, six, and twelve months following surgery.
The major endpoints were activity performance, estimated with the aid of Canadian Occupational Performance Measure (COPM; 1-10, where 1 = not able to perform), and the participant-reported impact of surgery on a 6-point scale that ranged from much worse to completely recovered.
For the noninferiority margin, an alteration of 2.0 points in the COPM was utilized. The secondary endpoints incorporated hand function, joint mobility, pain on a numerical rating scale (NRS), and pinch and grip strengths. Both intention-to-treat and per-protocol analyses were carried out.
Notably, 55/59 people finished all the evaluations. Regarding primary and secondary outcomes, no profound differences were noted at any time point, with the exception of more decreased pain at rest in the intervention group vs. the control group following twelve months. The per-protocol assessment did not reveal any profound inter-group differences in any of the outcomes.
Overall,
15 people witnessed 1 or more noxious events during the initial 3 months.
However, the types and frequencies of noxious events were similar between the
control and intervention groups. Thus, the findings of this study supported
trapeziectomy to reduce pain and improve activity performance and function in
people having first CMC osteoarthritis.
The Journal of Hand Surgery
Comparison of 2 Postoperative Therapy Regimens After Trapeziectomy due to Osteoarthritis: A Randomized, Controlled Trial
Merete Hermann-Eriksen et al.
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