Article

The trapeziometacarpal (TMC) joint of the human thumb is the second
most common joint in the hand affected by osteoarthritis.
TMC arthroplasty is a
common procedure used to alleviate symptoms.
No randomized controlled trials have been published on the efficacy of different post-operative orthotic regimes.
METHOD: Fifty six participants who underwent TMC arthroplasty were allocated to
either rigid orthotic or semi-rigid orthotic groups. Both groups started an
identical exercise program at two weeks following surgery. Outcome measures were
assessed by an assessor blinded to group allocation.
The primary outcome was the
Patient Rated Wrist and Hand Evaluation (PRWHE) and secondary outcomes included
the Michigan Hand Questionnaire (MHQ), thumb palmar abduction, first
metacarpophalangeal extension and three point pinch grip. Measures were taken
pre-operatively, at six weeks, three months and one year post-operatively.
Between-group differences were analyzed with linear regression. RESULTS: Both
groups performed equally well. There was no significant between-group difference
for PRWHE scores (0.47, CI -11.5 to 12.4), including subscales for pain and
function, or for any of the secondary outcomes at one year follow-up. CONCLUSION:
We found no difference in outcomes between using a rigid or semi-rigid orthosis
after TMC arthroplasty. Patient comfort, cost and availability may determine
choice between orthoses in clinical practice.
LEVEL OF EVIDENCE: 1b RCT.
CI - Copyright (c) 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS