Is Joint Denervation a Durable Treatment for Thumb Carpometacarpal Osteoarthritis? A Multicenter Long-Term Outcome Study

Vollständiger Abstract

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Background: Joint denervation for thumb carpometacarpal (CMC) osteoarthritis (OA) remains less commonly used, primarily due to concerns about the long-term durability of symptom relief. This study aims to assess the long-term reoperations and outcomes after CMC denervation and to identify prognostic factors associated with postoperative pain. Methods: This multicenter prospective study included patients with thumb CMC OA who underwent joint denervation. The primary outcome was the rate of reoperation due to recurrent CMC joint symptoms. Secondary outcomes included long-term pain and hand function measured using the visual analog scale (score, 0 to 100), as well as patient satisfaction. Results: A total of 69 patients (76 thumbs) undergoing CMC denervation were included. In 30% of cases, an additional partial wrist denervation (posterior interosseous nerve and anterior interosseous nerve) was performed for CMC OA. After a median follow-up of 30 months (range, 6 to 110 mo), 28% of thumbs underwent reoperation for recurrent complaints, with a median time to reoperation of 9 months. Visual analog scale pain and function scores improved significantly by 3 months and remained stable at long-term follow-up among those not requiring reoperation. At long-term follow-up, 66% of patients without reoperation reported that they would choose to undergo denervation again. Additional partial wrist denervation ( P = 0.001) and scaphotrapeziotrapezoid involvement ( P = 0.042) were associated with less pain improvement, whereas male sex was associated with more improvement ( P = 0.023). Conclusions: Joint denervation is an effective and durable treatment for CMC OA, with 72% not undergoing reoperation and reporting sustained improvements in pain and function. Additional partial wrist denervation did not show superior results and is therefore not recommended.