Recovery after Operative Treatment of Thumb Carpometacarpal Arthritis
Derek T. Schloemann, MD, MPHS1, Serena E. B. Liu, MD, MSc1, Joshua R. Atkinson, BSc1, David N. Bernstein, MBA, MA1, Ryan P. Calfee, MD MSc2 and Warren C. Hammert, MD3, (1)University of Rochester Medical Center, Rochester, NY, (2)Washington University in St. Louis School of Medicine, St. Louis, MO, (3)Department of Orthopaedics, University of Rochester, Rochester, NY
Purpose: Few data are available regarding the time course of recovery following surgical treatment of thumb CMC arthritis. Pain relief and functional improvement have been identified as patient expectations regarding treatment for this condition. It would benefit patients for clinicians to be able to provide counseling regarding the time course of recovery following surgery. This information may help physicians manage post-operative pain and could help patients understand the time course of functional improvement, which may lead to greater satisfaction with the operation. The purpose of this study was to describe the trajectory of mental and physical health following surgical treatment of thumb CMC arthritis.
Methods: This was a retrospective cohort study of 62 patients who underwent surgical treatment of CMC arthritis at a single institution. Box plots were generated to show mean PROMIS scores at all routine postoperative visits. Preoperative PROMIS scores were compared to early postoperative and late postoperative scores using a linear mixed model with time (preoperative, <3 months postoperative, ≥3 months postoperative) as the independent variable and PROMIS score as the dependent variable. Predicted scores at each time point based on the linear mixed model were presented.
Results: Fifty three percent of patients were female and 98% were white. PROMIS anxiety and depression scores decreased from preoperative to early postoperative time points and further decreased at late follow up. Physical function decreased immediately following surgery but improved above preoperative levels by one month and remained above preoperative levels at late follow up. Pain interference scores decreased at early post-operative time points and further decreased at late follow-up (Figure 1, Table 1).
Conclusions: Time course of recovery from surgical treatment of CMC arthritis has been described. This information may be help counsel patients regarding the recovery process following surgery.
Table 1. Predicted PROMIS scores over time from linear mixed model.
Figure 1. Box plots showing trajectory of PROMIS scores during recovery following surgical treatment.
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