Keywords
conservative treatment
Eaton–Littler stages
How to Cite
Abstract
Summary. The high prevalence of thumb carpometacarpal (CMC) osteoarthritis and the wide range of available conservative treatment options highlight the need for quantitative assessment of their effectiveness.
Objective. This study aimed to quantitatively evaluate the effectiveness of a multimodal conservative treatment program for thumb CMC osteoarthritis.
Materials and Methods. The outcomes of conservative treatment were evaluated in 270 patients with thumb CMC osteoarthritis (224 females and 36 males; median age 59 years, range 36–84, IQR 12). The treatment program included load modification, orthosis use, NSAIDs, physiotherapy, chondroprotective agents, and targeted therapeutic exercises. Changes in qDASH scores over time were assessed, as well as the rate of subsequent conversion to surgical treatment depending on the Eaton–Littler stage.
Results. Conservative treatment resulted in a reduction in upper-limb disability across all stages of the disease. In patients with stage I, median improvement in qDASH score was 7 points (range 4.5–9.1), with an interquartile range (IQR) of 4 points. For stage II, median improvement was 6.8 points (range 0–9.1), with an IQR of 4.6. Stage III demonstrated 5.7 points (range 4.5–13.7), with an IQR of 4.6, while stage IV showed 6.9 points (range 4.5–11), with an IQR of 4.6. High residual disability persisted in 52 patients (19%), requiring surgical intervention. Thus, initiating surgical treatment only after completing a structured conservative program demonstrates high effectiveness of this staged approach.
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