Joint distraction for thumb carpometacarpal osteoarthritis: a feasibility study with 1-year follow-up

Spaans, Anne J.; Minnen, L. Paul van; Braakenburg, Assa; Molen, Aebele B. Mink van der

doi:10.1080/2000656x.2016.1241789

Cited by 12 publications

(13 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Joint distraction is a fairly new treatment for patients with CMC1 OA [19]. To our knowledge, to date, 52 patients have been treated with joint distraction.…”

Section: Discussionmentioning

confidence: 99%

“…A distraction period of 6 weeks has not been studied for CMC1 OA specifically, but based on knee distraction studies, 6 weeks of continuous joint distraction seems to result in less pintract infections compared to an 8-week distraction duration (85% versus 55% respectively) [17,18]. However, it must be mentioned that pin tract infections occur more often during knee distraction than CMC1 joint distraction treatment [19].…”

Section: Potential Benefitsmentioning

confidence: 99%

“…Joint distraction is also feasible for the osteoarthritic CMC1 joint [19]. Nowadays, to our knowledge, more than 50 patients with persisting symptoms of CMC1 OA despite non-operative therapy were treated with CMC1 joint distraction.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Can we decrease the duration of basal thumb joint distraction for early osteoarthritis from 8 to 6 weeks? Study protocol for a non-inferiority randomized controlled trial

Ottenhoff

Teunis

Braakenburg

et al. 2021

Trials

Self Cite

View full text Add to dashboard Cite

Background To our knowledge, to date, 52 patients with thumb carpometacarpal osteoarthritis (CMC1 OA) were treated with joint distraction. So far, most patients experienced improved physical function and less pain. After 2 years, only 1 patient proceeded to trapeziectomy. This study assesses if we can safely lower the distraction duration from 8 to 6 weeks for CMC1 joint distraction, maintaining the improvement in physical function and pain. Methods This is a monocenter randomized controlled non-inferiority trial that includes patients younger than 65 years of age with ongoing symptoms of CMC1 OA and an established indication for surgery. All patients will be treated with CMC1 joint distraction. The primary outcome is to assess whether 6 weeks of joint distraction is not inferior to 8 weeks in terms of physical function at 1 year after surgery. Secondary outcomes will identify differences between groups at 1 year in pain intensity, patient satisfaction, hand health status, adverse event rates, treatment failure, differences in thumb strength and range of motion, and radiographic changes. Discussion If safe, the duration of basal thumb joint distraction can be reduced to 6 weeks, reducing patient burden. Because this is a relatively new treatment, this trial will provide greater knowledge of potential adverse events. This knowledge allows for more informed decision making for patients considering CMC1 distraction treatment. Future studies can directly compare joint distraction to other treatments of CMC1 joint arthritis like splinting and trapeziectomy. Trial registration Central Committee on Research Involving Human Subjects (CCMO), NL68225.100.18; registered on 9 August 2019. Medical Research Ethics Committees United (MEC-U), R19.003; registered on 9 August 2019. Netherlands Trial Register, NL8016; registered on 15 September 2019.

show abstract

“…Joint distraction is a fairly new treatment for patients with CMC1 OA [19]. To our knowledge, to date, 52 patients have been treated with joint distraction.…”

Section: Discussionmentioning

confidence: 99%

Section: Potential Benefitsmentioning

confidence: 99%

See 1 more Smart Citation

Can we decrease the duration of basal thumb joint distraction for early osteoarthritis from 8 to 6 weeks? Study protocol for a non-inferiority randomized controlled trial

Ottenhoff

Teunis

Braakenburg

et al. 2021

Trials

Self Cite

View full text Add to dashboard Cite

show abstract

“…Joint distraction has been utilized in the treatment of osteoarthritis of a variety of joints including the ankle, hip, and hand, with favorable outcomes 9–13. Studies focusing on knee joint distraction (KJD) in stopping and potentially reversing joint degeneration to delay knee arthroplasty in young patients have shown promise 14–19.…”

Section: Introductionmentioning

confidence: 99%

<p>The role of joint distraction in the treatment of knee osteoarthritis: a systematic review and quantitative analysis</p>

Goh¹,

Lou²,

Chidambaram³

et al. 2019

ORR

View full text Add to dashboard Cite

Introduction: Knee osteoarthritis is a major cause of pain and disability for which joint distraction is a potential treatment to delay the need for knee arthroplasty. This systematic review aims to assess the short-and long-term clinical and structural outcomes following knee joint distraction (KJD). Methods: MEDLINE, EMBASE, Scopus, and Web of Science databases were searched from the date of inception to 26th June 2019. Clinical studies investigating joint distraction for knee osteoarthritis with outcomes including ΔWOMAC index, ΔVAS pain score, and Δjoint space width were included. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO)-CRD42018087032. Results: Nine studies comprising a total of 507 patients were included. There were four randomized controlled trials (RCTs), five open prospective cohort studies, and one case series. Overall, there were significant improvements in WOMAC index, VAS pain score and joint space width following KJD, which persisted up to 9 years. KJD also demonstrated comparable clinical outcomes with high tibial osteotomy and total knee arthroplasty. Conclusion: There is moderate quality evidence supporting the beneficial outcomes of joint distraction for knee osteoarthritis. Larger RCTs with longer follow-up (>1 year) are necessary to establish the true effect size of this procedure.

show abstract

“…Fig.2Radiographs (A) before and (B) during distraction therapy, and (C) at 1-year and (D) at 2-year follow-up. Image Courtesy: Spaans et al12 …”

mentioning

confidence: 99%

Joint Distraction for Thumb Carpometacarpal Osteoarthritis: 2-Year Follow-up Results of 20 Patients

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Joint distraction is a fairly new treatment for patients with symptomatic thumb carpometacarpal osteoarthritis (CMC1 OA). A previous pilot study of five patients showed that CMC1 joint distraction is technically feasible. The current study presents the results of CMC1 joint distraction in 20 patients with a 2-year follow-up period. Purposes The primary study aim was to assess if patients with CMC1 OA have better physical function and less pain 2 years after CMC1 joint distraction. Second, we assessed the number of patients who achieved a minimal clinically important difference (MCID) in patient-reported outcome measures at each follow-up time point. Furthermore, this study sought differences on magnetic resonance imaging (MRI) of the CMC1 joint before and after distraction. Adverse events were noted and reported. Methods Twenty patients (median age of 54 years) with symptomatic CMC1 OA and an established indication for a trapeziectomy were enrolled. An external distractor device was placed over the CMC1 joint and left in situ for 8 weeks. Disabilities of the Arm, Shoulder, and Hand (DASH) score, Michigan Hand Outcome Questionnaire (MHQ), visual analogue scale (VAS), and grip strength were recorded preoperatively and at 3, 6, 12, and 24 months postoperatively. Results Two years after joint distraction, physical function and pain scores had improved significantly compared with baseline: DASH from 48 to 17, MHQ from 56 to 83, and VAS for pain from 50 to 18 mm. Fourteen of 19 patients (74%) reached an MCID in DASH and MHQ scores. One patient was not satisfied with treatment outcome and chose to proceed with a trapeziectomy 14 months after initial distraction therapy. Conclusions This study demonstrates that CMC1 joint distraction can postpone more invasive surgical interventions (e.g., trapeziectomy) for at least 2 years. Larger comparative studies are needed to assess the value of CMC1 joint distraction in the treatment of CMC1 OA. Level of Evidence This is a Level IV, prospective case series study.

show abstract

Joint distraction for thumb carpometacarpal osteoarthritis: a feasibility study with 1-year follow-up

Abstract: This study concludes that joint distraction of the osteoarthritic CMC1 joint is technically feasible. In this small, prospective pilot study the majority of the results were favourable during short-term follow-up.

Cited by 12 publications

References 14 publications

Can we decrease the duration of basal thumb joint distraction for early osteoarthritis from 8 to 6 weeks? Study protocol for a non-inferiority randomized controlled trial

Can we decrease the duration of basal thumb joint distraction for early osteoarthritis from 8 to 6 weeks? Study protocol for a non-inferiority randomized controlled trial

<p>The role of joint distraction in the treatment of knee osteoarthritis: a systematic review and quantitative analysis</p>

Joint Distraction for Thumb Carpometacarpal Osteoarthritis: 2-Year Follow-up Results of 20 Patients

Contact Info

Product

Resources

About