Frequency of multisite non-hand joint involvement in patients with thumb-base osteoarthritis, and associations with functional and patient-reported outcomes

Anthony V Perruccio; Elizabeth M Badley; Daniel Antflek; J Denise Power; Heather Baltzer

doi:10.1016/j.ocarto.2023.100397

Frequency of multisite non-hand joint involvement in patients with thumb-base osteoarthritis, and associations with functional and patient-reported outcomes

Osteoarthr Cartil Open. 2023 Aug 10;5(4):100397. doi: 10.1016/j.ocarto.2023.100397. eCollection 2023 Dec.

Authors

Anthony V Perruccio^{1

2

3

4}, Elizabeth M Badley^{1

2

5}, Daniel Antflek¹, J Denise Power¹, Heather Baltzer^{1

4}

Affiliations

¹ Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada.
² Arthritis Community Research and Epidemiology Unit (ACREU), Canada.
³ Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Canada.
⁴ Department of Surgery, Faculty of Medicine, University of Toronto, Canada.
⁵ Dalla Lana School of Public Health, University of Toronto, Canada.

Abstract

Purpose: In OA studies, the focus often is on an index-joint; other affected joint sites are often overlooked. In this thumb-base OA study, we documented the frequency of symptomatic non-hand joint sites and investigated whether their count was associated with thumb-specific functional and patient-reported outcome measures.

Design: Patients seeking care for thumb-base OA (conservative or surgical) were included. A patient-completed questionnaire captured sociodemographic and health characteristics, symptomatic hand and non-hand joint sites, and outcome measures (thumb-base pain intensity, symptoms and disability (TASD) and upper-extremity disability/symptoms (quickDASH)). Grip and pinch strength were measured. Linear regressions examined the association between each outcome and symptomatic joint site count, adjusted for several covariates.

Results: The mean age of the 145 patients was 62 years, 72% were female. Mean symptomatic non-hand joint site count was 3.6. Ten percent reported only their hands as symptomatic; 30% reported 2-3 other symptomatic sites, and 49% reported 4+. From cross-sectional multivariable analyses, a higher symptomatic non-hand joint site count was associated with worse scores for all patient-reported outcomes and grip strength. Every unit increase in joint site count (49% had a 4+ count) was associated with a 2.1-3.3 unit increase (worse) in patient-reported outcome scores (all p < 0.02).

Conclusions: In this sample, nearly 80% of patients had 2+ symptomatic non-hand joint sites. These symptoms were associated with worse thumb- and hand-specific outcomes, suggesting a need for awareness of whole body OA burden, with implications for outcome score interpretations, study designs, and provision of care in thumb-base OA.

Keywords: Disability; Grip strength; Multijoint symptoms; Pain; Patient-reported outcomes; Thumb-base osteoarthritis.