title: Midcarpal and Scaphotrapeziotrapezoid Arthritis in Patients with Carpometacarpal Arthritis.
abstract: BACKGROUND
  Carpometacarpal arthroplasty provides well-documented pain relief with preservation of thenar function in basal joint arthritis treatment. Nevertheless, some patients continue to have pain following surgery. The authors hypothesize that unrecognized midcarpal (capitolunate) arthritis is a contributor to persistent pain after carpometacarpal arthroplasty. The prevalence of midcarpal arthritis in patients with basal joint arthritis is unknown. This article establishes the radiographic prevalence of midcarpal arthritis in patients with carpometacarpal arthritis.
  
  
  METHODS
  Patients with basal joint arthritis were identified from a search using International Classification of Diseases, Ninth Revision code 716.94. Hand radiographs were reviewed and graded using the Eaton classification and Sodha classification for carpometacarpal arthritis. Scaphotrapeziotrapezoid arthritis and midcarpal arthritis were graded using the Sodha classification for arthritis as follows: grade 1, no or nearly no arthrosis; grade 2, definite arthrosis but not severe; and grade 3, severe arthrosis.
  
  
  RESULTS
  Eight hundred ninety-six radiographs were reviewed. The prevalence of scaphotrapeziotrapezoid arthritis in this population was 64 percent. The prevalence of midcarpal arthritis in this population was 23.5 percent. The prevalence of midcarpal arthritis in patients with radiologic evidence of carpometacarpal arthritis was 25.4 percent. The prevalence of severe midcarpal arthritis was 7 percent.
  
  
  CONCLUSIONS
  The prevalence of midcarpal arthritis in patients with basal joint arthritis is 24 percent. The presence of two locations of arthritis may explain persistent hand and wrist pain in this population despite carpometacarpal arthroplasty. Clinically, these data will allow hand surgeons to better educate patients with basal joint arthritis regarding the possibility of incomplete pain relief following carpometacarpal arthroplasty.
authors.affiliation: Pittsburgh and Philadelphia, Pa.|From the Departments of Plastic Surgery and Orthopedic Surgery, University of Pittsburgh; the Hand and UpperEx Center; the Division of Plastic Surgery, Hospital of the University of Pennsylvania; and the Perelman Center for Advanced Medicine.
authors.forename: Evan B
authors.initials: EB
authors.lastname: Katzel
authors.affiliation: Pittsburgh and Philadelphia, Pa.|From the Departments of Plastic Surgery and Orthopedic Surgery, University of Pittsburgh; the Hand and UpperEx Center; the Division of Plastic Surgery, Hospital of the University of Pennsylvania; and the Perelman Center for Advanced Medicine.
authors.forename: Dierde
authors.initials: D
authors.lastname: Bielicka
authors.affiliation: Pittsburgh and Philadelphia, Pa.|From the Departments of Plastic Surgery and Orthopedic Surgery, University of Pittsburgh; the Hand and UpperEx Center; the Division of Plastic Surgery, Hospital of the University of Pennsylvania; and the Perelman Center for Advanced Medicine.
authors.forename: Sameer
authors.initials: S
authors.lastname: Shakir
authors.affiliation: Pittsburgh and Philadelphia, Pa.|From the Departments of Plastic Surgery and Orthopedic Surgery, University of Pittsburgh; the Hand and UpperEx Center; the Division of Plastic Surgery, Hospital of the University of Pennsylvania; and the Perelman Center for Advanced Medicine.
authors.forename: John
authors.initials: J
authors.lastname: Fowler
authors.affiliation: Pittsburgh and Philadelphia, Pa.|From the Departments of Plastic Surgery and Orthopedic Surgery, University of Pittsburgh; the Hand and UpperEx Center; the Division of Plastic Surgery, Hospital of the University of Pennsylvania; and the Perelman Center for Advanced Medicine.
authors.forename: Glenn A
authors.initials: GA
authors.lastname: Buterbaugh
authors.affiliation: Pittsburgh and Philadelphia, Pa.|From the Departments of Plastic Surgery and Orthopedic Surgery, University of Pittsburgh; the Hand and UpperEx Center; the Division of Plastic Surgery, Hospital of the University of Pennsylvania; and the Perelman Center for Advanced Medicine.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Imbriglia
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*