Predictors of Disability After Treatment of Trapeziometacarpal Joint Arthrosis

Introduction Understanding the predictors of functional outcomes for both treatment approaches, surgical and conservative, is essential to optimize patient care, guide clinical decision-making, and set realistic expectations. Materials and Methods This retrospective observational study, approved by the institutional review board, included patients aged 40–75 with trapeziometacarpal joint arthrosis, treated either surgically or conservatively between 2013 and 2020. Patients completed surveys on demographics, including history of depression or anxiety and socioeconomic status (ESeC), and questionnaires on pain catastrophizing (PCS), anxiety (STAI) and depression (PHQ-9). Clinical assessments included measures of disability in hand function (Q-DASH), thumb mobility (Kapandji score), pain (VAS). The grade of trapeziometacarpal joint arthrosis was determined using the Eaton Littler classification. Results One hundred and forty-eight patients were initially approached to participate in this study. Of these, 132 patients with 168 cases completed all follow-up assessments and were included in the final data analysis. We found that female sex, young patients, more time to get treated, higher acute postoperative pain, the history of depression and anxiety prior to treatment and the non-operative treatment enhance the prediction of postoperative disability in patients treated of trapeziometacarpal joint arthrosis. Patients with elevated scores on anxiety, depression, and pain catastrophizing questionnaires (STAI, PHQ-9, and PCS) exhibited significantly greater levels of disability compared to those with lower scores. Conclusions The treatment outcomes of trapeziometacarpal joint arthrosis are influenced by a combination of demographics and psychological factors. A comprehensive understanding of these elements is crucial for developing effective treatment strategies and improving the quality of life for patients. By addressing the modifiable factors, such as not delaying surgical treatment or adequate management of preoperative analgesia, as well as the psychological needs of patients, healthcare providers can enhance treatment outcomes and ensure more equitable and effective care.