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Midcarpal and STT arthritis in patients with CMC arthritis
Evan B. Katzel, Dierde Bielicka, Sameer Shakir, John Fowler, Glenn A Buterbaugh, Joseph E. Imbriglia
UPMC
2016-02-03
Presenter: Evan Katzel
Affidavit:
Joseph E Losee
Director Name: Joseph E Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Introduction
Carpometacarpal (CMC) arthroplasty provides well-documented pain relief with
preservation of thenar function. Nevertheless, a segment of the population undergoing
this procedure will continue to have pain following surgery. The authors hypothesize
that unrecognized midcarpal (capitolunate) arthritis is a major contributor to persistent
pain after CMC arthroplasty. The prevalence of midcarpal arthritis in patients with
basal joint arthritis is unknown. The goal of this study is to establish the radiographic
prevalence of midcarpal arthritis in patients with CMC arthritis and/or STT
(scaphotrapezotrapezoid) arthritis.
Methods
Patients with basal joint arthritis were identified from a billing search using ICD-9 code
716.94. Hand radiographs were retrospectively reviewed and graded using the Eaton
classification and Sodha classification for CMC arthritis. STT arthritis and midcarpal
arthritis were graded using the Sodha classification for arthritis.
Results
896 x-rays were reviewed. The overall prevalence of STT arthritis in this population
was 64%. The overall prevalence of midcarpal arthritis in this population was 23.5%.
The prevalence of midcarpal arthritis in patients with radiologic evidence of CMC
arthritis was 25.4%. The prevalence of severe midcarpal arthritis was 7%.
Conclusions
The prevalence of midcarpal arthritis in patients with basal joint arthritis is 24%. The
presence of two locations of arthritis may explain persistent hand and wrist pain in this
population despite CMC arthroplasty. Clinically, this data will allow hand surgeons to
better educate patients with basal joint and midcarpal arthritis regarding the possibility
of incomplete pain relief following CMC arthroplasty
