Classifications in Brief: The Eaton-Littler Classification of Thumb Carpometacarpal Joint Arthrosis

Kennedy, Colin D.; Manske, M. Claire; Huang, Jerry I.

doi:10.1007/s11999-016-4864-6

Cited by 45 publications

(39 citation statements)

References 25 publications

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“…The modified Eaton-Littler classification is frequently used to radiographically grade first CMC OA [9,14,30]. This system, specific to joints at the base of the thumb, has four grades that collectively rate osteophytes, joint-space narrowing, subluxation, and scaphotrapezial involvement [14] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Assessments of Hand Function in First Carpometacarpal Osteoarthritis Do Not Appear to Correlate with Radiographic Findings

2019

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Background: Thumb carpometacarpal (first CMC) osteoarthritis (OA), a degenerative process affecting hand use, is typically assessed by clinical examination and radiographs. This assessment determines treatment, but it may not reflect functional limitations. Questions/Purposes: We aimed to explore the relationship between measures of hand function and radiographs in individuals with and without first CMC OA. Methods: We designed a cross-sectional, observational pilot study, enrolling five patients with first CMC OA (nine thumbs with modified Eaton-Littler grades ranging from 1 to 4, using retrospective radiographic data) and nine healthy controls. They underwent evaluation of hand function using four patient-reported outcome measures (PROMs)-the Patient-Specific Functional Scale (PSFS); the Patient-Rated Wrist/Hand Evaluation (PRWHE); the Disabilities of the Arm, Shoulder, and Hand (DASH); and the Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (M-SACRAH)-and one performance measure, the Arthritis Hand Function Test (AHFT). Spearman's ρ with 95% subject clustered bootstrapped confidence intervals was calculated to assess for correlations between radiographic findings and measures of hand function. Results: Only the DASH work score showed strong positive correlation with radiographic OA grade, with PSFS, PRWHE, M-SACRAH, and AHFT scores demonstrating low to moderate correlations. Notable differences were found between patients and control subjects in median scores of the DASH, PSFS, PRWHE, and M-SACRAH, as well as in the grip, pinch, and button scores of the AHFT. Conclusion: While only the DASH work score strongly correlated with radiographic grade of first CMC OA, several measures detected considerable differences in functional hand use between patients and control subjects. The findings of this pilot study suggest that hand function scores be considered in addition to radiographs when determining severity of first CMC OA. The findings can also inform the design of a larger, powered study. Keywords first carpometacarpal osteoarthritis. radiographic grading. basilar joint. functional hand measures. patient reported outcome measures

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Section: Introductionmentioning

confidence: 99%

“…1). The most commonly used system to describe first CMC OA in clinical practice [14,30], the modified Eaton-Littler classification is one factor guiding treatment recommendations [9], but concerns have been raised on its association with reported functional performance or clinical presentation [13,30].…”

Section: Introductionmentioning

confidence: 99%

Clinical Assessments of Hand Function in First Carpometacarpal Osteoarthritis Do Not Appear to Correlate with Radiographic Findings

2019

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“…Afterwards, inclusion and exclusion criteria are assessed. Main inclusion criteria are a definite diagnosis of OAT according to the stage I to IV Eaton and Littler X-ray criteria [38] and clinical symptoms in the region of the thumb base for at least 3 months.…”

Section: Participantsmentioning

confidence: 99%

Study of Medical Ultrasound for Rhizarthrosis (SUR): study protocol for a randomized controlled single-center pilot-trial

Böck

Eisenschenk

Lorenzen

et al. 2020

Trials

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Background: Rhizarthrosis (trapeziometacarpal osteoarthritis) is the second most common site of osteoarthritis in the hand affecting 10-30% of adults over the age of 50. Up to four times as many women as men have rhizarthrosis. Clinical symptoms include functional disability of the thumb, pain, joint swelling, and reduced strength. The first carpometacarpal joint is pivotal in the opposition of the thumb and allows a high degree in flexibility to humans. Current therapies focus mainly on surgical strategies, which should be considered in advanced, therapy-resistant stages to relieve pain and improve function. However, conservative treatment methods are urgently required in presurgical stages. The efficacy of conservative treatment options for rhizarthrosis, which are intended to preserve function, joint integrity and to relieve pain, has not been adequately studied. In the clinical study protocol presented here, we investigate the efficacy of multimodal hand therapy versus therapeutic ultrasound versus combination therapy with both hand therapy and therapeutic ultrasound. Methods: This study is a single-center, randomized, controlled, parallel-group pilot trial. One hundred fifty patients with rhizarthrosis and current disease activity will be randomized to one of three conservative interventions over 6 months. Interventions are (1) multimodal hand therapy (2) therapeutic ultrasound, and (3) combination therapy with both hand therapy and ultrasound therapy. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score after 6 months. Secondary endpoints are changes in pain, quality of life, disability progression, and changes of hand function. Safety will also be assessed. Discussion: Clinical data suggest that multimodal hand therapy may improve functionality and reduce pain in rhizarthrosis. Clinical data regarding therapeutic ultrasound are not available. Clinical evidence is lacking. This study is the first clinical study investigating the effects of multimodal hand therapy in direct comparison to therapeutic ultrasound and to a combination therapy with both hand therapy and ultrasound therapy for rhizarthrosis.

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“…The Eaton-Littler classification is the most common radiographic classification system for basilar thumb arthrosis and is used to confirm the diagnosis. 6 …”

Section: Introductionmentioning

confidence: 99%

Autologous fat transplantation for the treatment of trapeziometacarpal joint osteoarthritis

Alessandri‐Bonetti¹,

Rovere²,

Fulchignoni³

et al. 2020

Orthop Rev (Pavia)

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Rhizarthrosis is a progressive and disabling pathology affecting the carpometacarpal joint. It’s very common in elderly patients and typically affects postmenopausal women. The diagnosis of rhizarthrosis is mainly made by using different physical examination tests and by evaluating the type of pain and it’s then confirmed by imaging. Over the last few years increasing attention has been devoted to the assessment of new treatment techniques for rhizarthrosis. In this context intra-articular injection of autologous fat grafting for cartilage regeneration has demonstrated promising results in experimental settings as an alternative to open surgery procedures. The aim of this study was therefore to sum up the evidences available so far on autologous fat grafting as an emerging treatment for patients affected by carpometacarpal rizarthrosis. An electronic literature research was carried out on Pubmed, Google Scholars and Cochrane Library using “fat grafting”, “fat graft”, “adipose”, “fat transfer” and “lipoaspirate” as search terms. Authors believe autologous fat grafting is an interesting technique, that hand surgeon should keep in mind especially in early stages of rhizarthrosis were pain has not been solved with non-surgical treatment.

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Classifications in Brief: The Eaton-Littler Classification of Thumb Carpometacarpal Joint Arthrosis

Cited by 45 publications

References 25 publications

Clinical Assessments of Hand Function in First Carpometacarpal Osteoarthritis Do Not Appear to Correlate with Radiographic Findings

Clinical Assessments of Hand Function in First Carpometacarpal Osteoarthritis Do Not Appear to Correlate with Radiographic Findings

Study of Medical Ultrasound for Rhizarthrosis (SUR): study protocol for a randomized controlled single-center pilot-trial

Autologous fat transplantation for the treatment of trapeziometacarpal joint osteoarthritis

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