Radiographic Stage Does Not Correlate With Symptom Severity in Thumb Basilar Joint Osteoarthritis

Hoffler, C. Edward; Matzon, Jonas L.; Lutsky, Kevin; Kim, Nayoung; Beredjiklian, Pedro K.

doi:10.5435/jaaos-d-15-00329

Cited by 35 publications

(23 citation statements)

References 22 publications

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“…However, no correlation between the QuickDASH and Eaton-Littler scores has been described in the literature. 11 In comparison to the Eaton-Littler score, the ThOA index and the Eaton-Glickel score showed slightly higher reproducibility, with higher intraclass correlation coefficients (Eaton-Littler score of 0.73 vs. ThOA index of 0.95 vs. Eaton-Glickel score of 0.83); however, they are not as widely accepted and may require a special radiographic view. The Roberts view (ThOA), which is not routinely performed, could address some of the gaps in the previous scores.…”

Section: Discussionmentioning

confidence: 86%

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Thumb Disability Examination (TDX) as a New Reliable Tool for Basal Joint Arthritis

et al. 2020

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Background The general assessment of basal joint arthritis (BJA) is limited using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. This has been shown to be insensitive to pain and disability levels, leading to the development and validation of the thumb disability examination (TDX) as a specific tool for BJA in 2014. Objective The goal of this study was to evaluate the reliability, sensitivity, and specificity of the TDX score for BJA. Methods A multicenter BJA database was established in 2007 to collect prospective data. We evaluated the correlation between the TDX score, visual analog pain scale with activity (A-VAS), Eaton–Littler score, and grip strength using a Pearson test. Additionally, we evaluated the pre- and postintervention scores to assess their predictive values. Results A total of 109 thumbs of 74 patients with TDX scores were evaluated. Females were more commonly affected (75.2%), and the mean age was 65.39 years (standard deviation: 10.04). The majority of participants were white (90.8%). A high correlation between TDX and A-VAS score (Pearson's correlation = 0.520; p < 0.001) and between grip strength (Pearson's correlation = –0.336; p < 0.005) and Eaton–Littler score (Pearson's correlation = 0.353' p < 0.01) was identified. Additionally, when comparing pre- and post-intervention for all treatment groups and for operative intervention, significant differences in TDX scores were observed (both p ≤ 0.01). No significant differences could be identified for DASH score or A-VAS when assessing these same groups. Conclusion The TDX score correlates to high Pearson's correlation values and p-values, especially in grip strength, Eaton–Littler score, A-VAS score, and pre-/postintervention for all treatment groups combined and when specifically assessing the surgical intervention group. As a result, it can be concluded that the TDX score is a specific tool for the assessment of BJA. Level of Evidence This is a Level II, prospective comparative study.

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Section: Discussionmentioning

confidence: 86%

“…Furthermore, there has been no reported correlation between the Eaton-Littler score and the QuickDASH score in the literature. 6,10,11 Therefore, the indication for treatment relies heavily on hand surgeon experience.…”

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confidence: 99%

Thumb Disability Examination (TDX) as a New Reliable Tool for Basal Joint Arthritis

et al. 2020

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“…Previous studies demonstrated that clinical symptoms of the osteoarthritis of the thumb CMC joint may not cor respond to radiographic findings. 15,16 Hoffler et al showed that radiographic severity does not correlate with valid ated patientreported symptom scores, although they used radio graphic staging by Eaton et al in 1984, 2 which does not include subluxation as defining criteria. 16 Further study is required on the correlation between radiographic severity incorporating dorsal subluxation and clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Dorsal Subluxation in Thumb Carpometacarpal Osteoarthritis

et al. 2018

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Background Although dorsal subluxation is a typical finding for osteoarthritis of the thumb carpometacarpal (CMC) joint, it is difficult to evaluate the subluxation after trapeziectomy and the significance of its surgical correction combined with trapeziectomy is still controversial. The purpose of this study was to develop a method to evaluate dorsal subluxation without using landmarks on the trapezium. Methods Thirty patients with thumb CMC arthritis and 13 normal patients were included in this study. Dorsal subluxation of the CMC joint was evaluated by measuring the distance between the volar tip of the thumb metacarpal base and dorsoradial border of the index metacarpal base (M1M2 overlap) on the X-ray true lateral view of the thumb as well as previously reported methods. Intraclass correlation coefficient (ICC) was used to assess inter- and intraobserver reliability for the measurement of M1M2 overlap by six examiners of different level of expertise. Dorsal subluxation was also evaluated after trapeziectomy with ligament reconstruction. Results There were almost perfect interobserver (ICC = 0.94) and intraobserver (ICC = 0.95 for an expert and 0.97 for a novice) reliabilities for the measurement of M1M2 overlap. There was a weak correlation between our method and previously reported methods. M1M2 overlap of the normal patients and the patients were 4.6 ± 1.2 mm and 2.3 ± 2.3 mm (mean ± SD), respectively. M1M2 overlap was corrected significantly after trapeziectomy with ligament reconstruction. Conclusion Dorsal subluxation of the thumb CMC joint could be evaluated by M1M2 overlap before and after trapeziectomy.

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“…A painful unstable non‐arthritic thumb CMC joint can be stabilized surgically, with a good prognosis [Eaton and Littler, ]. Unfortunately, radiographs do not correlate with symptoms [Hoffler et al, ], and patients must be examined carefully by specialists with extensive subspecialty training. Thumb MP joint hyperextension instability can be treated with soft tissue stabilization and/or extensor pollicus brevis tenodesis, or more reliably with arthrodesis.…”

Section: Surgical Treatment Options For Eds Patientsmentioning

confidence: 99%

Orthopaedic management of the Ehlers–Danlos syndromes

Ericson

Wolman²

2017

American J of Med Genetics Pt C

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The role of orthopedic surgery in Ehlers-Danlos syndrome is inherently controversial, opaque to most patients and many medical providers, and difficult to discern from available medical literature. Non-operative treatment is preferable, but for carefully selected patients, specific joint stabilization and nerve decompression procedures can provide symptomatic relief when conservative measures fail.

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Radiographic Stage Does Not Correlate With Symptom Severity in Thumb Basilar Joint Osteoarthritis

Abstract: Prognostic, level II.

Cited by 35 publications

References 22 publications

Thumb Disability Examination (TDX) as a New Reliable Tool for Basal Joint Arthritis

Thumb Disability Examination (TDX) as a New Reliable Tool for Basal Joint Arthritis

Assessment of Dorsal Subluxation in Thumb Carpometacarpal Osteoarthritis

Orthopaedic management of the Ehlers–Danlos syndromes

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