Basal thumb osteoarthritis surgery improves health state utility irrespective of technique: a study of UK Hand Registry data.

Jennifer C E Lane,Robert Poulter,Matthew D Gardiner,Jeremy N Rodrigues,Edward Burn,Dominic Furniss

doi:10.1177/1753193420909753

Abstract

We used UK Hand Registry data to study two aspects of basal thumb osteoarthritis surgery: first, whether health-related quality of life improves after surgery. Second, whether results from trials comparing simple trapeziectomy and trapeziectomy with ligament reconstruction and tendon interposition are reproducible in routine clinical practice. Prospectively collected EQ5D index and Patient Evaluation Measure part 2 data were compared at baseline and at 3, 6, and 12 months postoperatively in 1456 patients (median age 67 years; 78% female). A mixed-effects regression model was also used to determine the postoperative trajectory of these variables. There was a significant improvement in the EQ5D index (median + 0.15; (interquartile range 0 to 0.40)) and Patient Evaluation Measure (–22; (–33 to –10)) by 1 year postoperatively and with no meaningful difference between the two techniques. This study demonstrates health state utility gains after basal thumb osteoarthritis surgery regardless of surgical techniques used.Level of evidence: III

Highlights

The choice of surgical method for treating base of thumb osteoarthritis (BTOA) remains controversial (Brunton and Wilgis, 2010; Deutch et al, 2018)
Over the 6-year inclusion period, 1456 patients were added to the UK Hand Registry (UKHR), of which 749 underwent trapeziectomy alone and 648 underwent trapeziectomy with ligament reconstruction and tendon interposition (LRTI) (Supplementary Figure 1)
This study shows that hand function and health state utility improve substantially after both trapeziectomy and trapeziectomy with LRTI in a UK population

Summary

Introduction

The choice of surgical method for treating base of thumb osteoarthritis (BTOA) remains controversial (Brunton and Wilgis, 2010; Deutch et al, 2018). Randomized control trials (RCTs) have shown little difference between procedures (Davis et al, 2004; De Smet et al, 2004; Field and Buchanan, 2007; Gangopadhyay et al, 2012; Wajon et al, 2015). These studies focus on comparing techniques of surgery for BTOA. In BTOA surgery, there have been no national studies that have analysed preoperative health state utility, or used health state utility to compare surgical techniques (Efanov et al, 2019; Maru et al, 2012; Varitimidis et al, 2000; Yeoman et al, 2019)

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