Highlights
- •Trapeziometacarpal osteoarthritis produces significant impairment, but few studies have related radiographic scores to functional and pain-based measures.
- •Use of generalized estimating equations enabled analysis of bilateral data, eliminating confounding personal variables.
- •More advanced radiographic Trapeziometacarpal osteoarthritis is associated with lower grip strength and poorer self-reported functional outcomes
- •Lower radial subluxation scores are associated with higher pain scores and lower grip strength.
Abstract
Introduction
Trapeziometacarpal joint osteoarthritis (OA) produces significant functional impairment
due to pain and loss of strength in both power and precision grips, but few studies
have related radiographic scores to functional and pain-based measures.
Purpose
To investigate the association between markers of radiographic disease and outcomes
for symptomatic and functional disease.
Study Design
This study in an exploratory analysis of baseline data from the first 100 participants
in a clinical trial evaluating the efficacy of combined conservative therapies for
base of thumb OA (COMBO).
Methods
Functional Index for Hand Osteoarthritis (FIHOA) scores and Visual Analogue Scale
(VAS) scores for pain were recorded for the index hand. Bilateral isometric grip and
tip-pinch strength measurements were taken, as well as posteroanterior and Eaton stress-view
hand radiographs. Generalized estimating equations (GEEs), univariate, and multivariate
analyses were used according to whether the data were bilateral or unilateral.
Results
A total of 79 females and 21 males were included, with a median Kellgren-Lawrence
(KL) grade of 3 in the index hand. Higher KL and Eaton grades were associated with
lower grip strength in the GEE analysis (B-coefficients of -1.25 and -1.16, and P-values of .002 and .010, respectively). Higher KL grade was also associated with
poorer function and higher pain levels in the multivariable analysis (B-coefficients
of 1.029 and 3.681, and P-values of .021 and .047, respectively). Lower radial subluxation ratios were associated
with lower grip strength in the GEE analysis, and higher pain scores in the multivariable
analysis (B-coefficients of 2.06 and -42.1, and P-values of .006 and .031, respectively). Greater pain scores were also associated
with poorer function (B-coefficient 0.082, P-value .001).
Conclusion
More advanced radiographic trapeziometacarpal OA severity is associated with lower
grip strength and poorer self-reported functional outcomes. Lower subluxation ratios
were associated with higher pain scores and lower grip strength.
Keywords
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Article info
Publication history
Published online: December 31, 2021
Accepted:
October 2,
2021
Received in revised form:
April 14,
2021
Received:
December 2,
2020
Publication stage
In Press Corrected ProofFootnotes
Conflict of interests: DJH is a consultant to Pfizer, Lilly, TLCBio and Merck Serono. LD received partial reimbursement of conference registration cost from Pfizer.
Funding: This work was supported by National Health and Medical Research Council (NHMRC) Program Grant (grant number APP1091302) and by the Lincoln Centre for Bone and Joint Diseases. KB is supported by an NHMRC Principal Research Fellowship. DH is supported by an NHMRC Practitioner Fellowship. The funder had no role in the study design.
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