Study Compares Predictors of CMC OA Progression

By: Maureen Leahy

Results of Scientific Poster P721, on display in Academy Hall B, indicated that functional tests are superior to patient-reported outcome measures (PROMs) at predicting progression of carpometacarpal (CMC) osteoarthritis (OA).

“We conducted our investigation to determine how strength, range of motion (ROM), and PROMs change over a 36-month period in patients with early CMC OA,” explained coauthor Joseph Gil, MD.

The primary goal was to identify whether functional assessments or PROMs were more sensitive at identifying progression of CMC OA at 18- and 36-month follow-up.

Secondarily, the researchers sought to determine which specific functional assessment or PROM most strongly correlated with radiographic progression of CMC OA.

Study design

The study involved 91 patients with early symptomatic and radiographic thumb CMC OA. For all patients, the researchers collected demographic information, comprehensive history, plain film radiographs, as well as ROM and functional test assessments (maximum grip strength, lateral key pinch, three-finger pinch, two-finger pinch), and PROMs questionnaires: Australian/Canadian Hand Osteoarthritis Index (AUSCAN) and Patient-Rated Wrist & Hand Evaluation (PRWHE).

Differences in strength, ROM, and PROMS were compared between CMC OA patients at baseline, 18-month, and 36-month follow-up using a paired two-sample t-test. Measures of joint function were compared between baseline and 18 months as well as between baseline and 36 months. Differences in strength, ROM, and PROMS in CMC OA patients at 18- and 36-month follow-up were compared between patients with and without radiographic progression using paired two-sample t-test.

Interpreting the findings

The study’s results revealed that at the 18- and 36-month follow-up visits, patients with CMC OA had significant losses in strength and range of motion. They did not have any statistically significant changes in their PROMS.

“When comparing patients with radiographic progression of CMC OA to those patients without radiographic progression at 36 months, there were no significant differences in strength, PROMS, or ROM between patients with radiographic progression of CMC OA and those patients without radiographic progression,” said Dr. Gil. He added, “Our results indicated that CMC OA progression in patients with early CMC OA is not reliably determined based on radiographic progression alone.”

Dr. Gil’s coauthors of “Functional Tests versus Patient-Reported Outcomes in Predicting Thumb Carpometacarpal Arthritis Progression: a Prospective, Longitudinal Study” are Justin Everett Kleiner, BS; Joseph Crisco, PhD; Amy L. Ladd, MD; and Arnold-Peter C. Weiss, MD.

Maureen Leahy is assistant managing editor of AAOS Now. She can be reached at leahy@aaos.org.

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