Risk factors for residual pain after ligament reconstruction and tendon interposition on osteoarthritis of the first carpometacarpal joint

Abstract

Background: Ligament reconstruction and tendon interposition (LRTI) is currently the most performed procedure for osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint. In general, satisfactory outcomes are expected, although some patients complain of residual pain after LRTI. The objective of this study is to determine the factors associated with residual pain. Method: All patients with OA of the thumb CMC joint who underwent LRTI at our hospital between October 2013 and October 2018 and were regularly observed for at least 1 year were included. The following variables were extracted and included in the univariate analysis: sex, age, dominant hand, pain visual analog scale (VAS) score, Eaton classification, grip strength, pulp pinch strength, and metacarpophalangeal joint hyperextension angle were recorded as variables. Mann-Whitney U test or Fisher exact test was used for univariate analysis of the above factors, and then multivariate logistic regression analysis was performed to find out the factors associated with residual pain. Results: The study included 60 thumbs of 53 patients. Eleven thumbs had postoperative residual pain. The surgery on the dominant hand was significantly associated with the presence of postoperative residual pain, especially in males. Conclusions: Dominant hand was associated with residual pain after LRTI for OA of the thumb CMC joint, although residual pain was minimal. Our findings will help in preoperative and postoperative counseling of patients. In the future, our results may also help select surgical procedures according to the patient’s characteristics.