Equivalent PROMIS Scores after Nonoperative or Operative Treatment of Trapeziometacarpal Osteoarthritis

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) scores can quantify symptomsand limitations after upper extremity surgery. Our objective was to determine how these scores compare amongstpatients with trapeziometacarpal osteoarthritis treated either nonoperatively or operatively.Methods: In this retrospective comparative study, we compared PROMIS scores (upper extremity function [UEF],pain interference, and depression) between 43 patients who underwent nonoperative treatment (nonsteroidal antiinflammatorydrugs/splinting/injections) and 33 patients who underwent trapeziectomy with ligament reconstructionand tendon interposition for trapeziometacarpal osteoarthritis (minimum 6-month recovery period) by 4 surgeons from2014–2018. PROMIS scores were compared across all patients by Eaton-Littler staging. We used linear regression toassess correlations between time-since-surgery and each PROMIS domain. Multivariable linear regression was usedto identify patient and disease factors independently associated with PROMIS scores.Results: Surgery was not associated with better UEF (37 vs. 40, P=0.23), less pain interference (58 vs. 56, P=0.42),or fewer symptoms of depression (47 vs. 46, P=0.59). Similarly, no differences were observed across all patient byEaton-Littler stage for UEF (P=0.49), pain (P=0.48), or depression (P=0.90). For the operative group, greater timesince-surgery, or patient recovery period, correlated moderately with worse UEF (R=0.41) and increased pain (R=0.37).Conclusion: In small retrospective comparative cohorts, surgery was not associated with better UEF, pain, ordepression scores compared with nonoperative treatment for trapeziometacarpal osteoarthritis.Level of evidence: III

Keywords:

ligament reconstruction tendon interposition , outcomes , Patient-Reported Outcomes Measurement Information System , Thumb carpometacarpal joint osteoarthritis , Trapeziometacarpal osteoarthritis