Back to 2026 ePosters
Impact of Eaton-Littler Classification on Clinical Management and Outcomes in Thumb Carpometacarpal Joint Arthritis
Samantha Maasarani, M.D., M.P.H.
1, Daniel JP Bahat, MD
2,3, Samara Kass, BS, BA
4, Christopher Jou, MD
1, Adrienne Lee, MD
1; Kyle J. Chepla, MD
5(1)Metro Health Medical Center, Cleveland, OH, (2)Cleveland Clinic, Cleveland, OH, (3)Cleveland, Cleveland, OH, (4)Case Western Reserve University School of Medicine, Cleveland, OH, (5)Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH
Hypothesis:Eaton-Littler (EL) classification would correlate with clinical management of patients with symptomatic thumb carpometacarpal joint (CMC) arthritis. In particular, we hypothesize that lower EL classification would be treated conservatively (splinting, steroids) and higher EL classification would be treated with surgery.
Methods:A retrospective cohort analysis was performed of all patients with thumb CMC arthritis evaluated by a hand surgeon at Metro Health Medical Center between 2000-2024. Patients were stratified into four cohorts depending on their Eaton-Littler (EL) Classification at time of initial evaluation. Treatment type, mean number of corticosteroid injections (CSI), time-to-surgery, postoperative complications, and revision rates were reviewed.
Results:A total of 762 patients with thumb CMCJ arthritis were included in our study and stratified into cohorts by Eaton-Littler Classification (EL-1: n=93, EL-2: n=284, EL-3: n=266, EL-4: n=119). Overall, patients were female (73.4%), White (77.4%), never used tobacco/nicotine (45.7%), right-handed (91.5%), and had bilateral disease (38.6%). The majority of patients received CSI as a treatment regardless of their EL classification (EL-1: 57.0%, EL-2: 56.0%, EL-3: 45.5%, EL-4: 42.0%). The rates of splinting were highest in EL-1 (31.2%) and EL-4 (28.6%), while the rates of surgery were highest in EL-3 (33.5%) and EL-4 (29.4%). The mean number of CSI received was only statistically significant when comparing EL-3 (2.94 +/- 3.78) and EL-1 (1.75 +/- 2.74). The mean difference in time from index-CSI -to-surgical intervention was statistically significant when comparing EL-3 (83.6+/-58.4 months) vs EL-1 (110+/-40.2 months) and EL-3 (83.6+/-58.4 months) vs. EL-2 (103.0+/-106.0 months). For patients undergoing surgical intervention, there was no significant difference in postoperative complications (EL-1: 2.2%, EL-2: 6.3%, EL-3: 5.3%, EL-4: 5.9%, p=0.77) or need for revision surgery (EL-1: 9.1%, EL-2: 16.7%, EL-3: 5.6%, EL-4: 2.9%, p=0.18).
Summary Points:Eaton-littler classification is a common radiologic diagnosis used to describe thumb CMC arthritis, which parallels clinical management. We found that individuals with EL-3 received on average significantly more CSIs and underwent conversion from CSI-to-surgical intervention fastest. While EL-classification correlates with treatment, it does not predict postoperative complications or need for revision surgery.
Back to 2026 ePosters
