title: Painful thumb carpometacarpal joint osteoarthritis: Results of a novel treatment approach.
abstract: BACKGROUND
  Pain reduction as well as preservation and improvement in range of motion remain the main aims in the treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). We performed a retrospective outcome analysis of patients with symptomatic stage II-III thumb CMC joint arthritis treated with denervation, joint lavage and capsular imbrication.
  
  
  METHODS
  73 patients with stage II to III OA of the thumb CMC-joint underwent the described technique. A total of 42 patients complied with follow-up assessment and were included in this study. Mean follow-up was 41.2 (range 12-81) months.
  
  
  RESULTS
  Mean operative time was 28.4 (±6.5) minutes. The follow-up assessments showed a significant decrease in pain (preoperative Numerical Rating Scale (NRS): 7.5 - postoperative NRS: 1.1) (p < 0.0001) and a significant improvement in function of the thumb (preoperative DASH-Score: 46.8; Cooney-Wrist-Score: 35.4; Krimmer-Wrist-Score: 38.3 - postoperative DASH-Score: 18.1; Cooney-Wrist-Score: 73.7; Krimmer-Wrist-Score: 80.0) (p < 0.0001).
  
  
  CONCLUSIONS
  The findings of our study indicate that the presented treatment approach could be a good alternative to more invasive surgical options in patients with stage II-III CMC OA of the thumb, without impairing more invasive surgical options like trapeziectomy or arthroplasty for the future.
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Hospital, 81925 Munich, Germany. Electronic address: Denis.Ehrl@klinikum-muenchen.de.
authors.forename: Denis
authors.initials: D
authors.lastname: Ehrl
authors.affiliation: Department of Plastic, Aesthetic Surgery and Hand Surgery, Kreisklinik Ebersberg, Pfarrer-Guggetzer-Str. 3, 85560 Ebersberg, Germany.
authors.forename: Holger C
authors.initials: HC
authors.lastname: Erne
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Hospital, 81925 Munich, Germany.
authors.forename: P Niclas
authors.initials: PN
authors.lastname: Broer
authors.affiliation: Department of Plastic, Aesthetic Surgery and Hand Surgery, Kreisklinik Ebersberg, Pfarrer-Guggetzer-Str. 3, 85560 Ebersberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Metz
authors.affiliation: Department of Plastic, Aesthetic Surgery and Hand Surgery, Kreisklinik Ebersberg, Pfarrer-Guggetzer-Str. 3, 85560 Ebersberg, Germany.
authors.forename: Erwin
authors.initials: E
authors.lastname: Falter
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods; D052737:Carpometacarpal Joints / Q000473:pathology / Q000503:physiopathology; D003714:Denervation / Q000009:adverse effects / Q000379:methods; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D062072:Patient Acuity; D016059:Range of Motion, Articular; D013933:Thumb / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome
keywords: Denervation; Eaton littler stage II and III; First carpometacarpal (CMC) joint; Osteoarthritis; Thumb