Usefulness of custom-made orthoses with 3D scanning and printing for the conservative treatment of rhizarthrosis.

Abstract

Background: Trapeziometacarpal osteoarthritis (rhizarthrosis) is often managed with orthopedic orthoses that are prefabricated in various sizes and may be manipulated to be adapted to the patient's anatomy. Advances in three-dimensional scanning and printing now allow fabrication of anatomically matched custom-made orthoses.

Objectives: To assess the feasibility and effectiveness of a 3D-printed orthosis compared with custom-fitted orthoses in the conservative treatment of rhizarthrosis.

Study design: Feasibility randomized controlled study.

Methods: Thirty-nine patients (42 hands) without prior treatment were randomized into 2 groups: custom-fitted orthoses (n = 21 hands) and 3D-printed orthoses (n = 21 hands). Data on sociodemographic characteristics, pain (measured by visual analog scale), grip and pinch strength (using a dynamometer), and functional outcomes (DASH score) were collected at baseline, 1 month, and 3 months. Treatment adherence and patient satisfaction were also evaluated.

Results: Pain levels decreased in both groups, with a more pronounced improvement in the 3D-printed group at 1 month (between-group difference -1.14, 95% CI -2.25 to -0.33, p < 0.05). Patients using 3D-printed orthoses also reported higher satisfaction (45.0 ± 6.97 vs 35.5 ± 9.36, p < 0.001). Both groups showed improvements in DASH scores, with greater gains in the 3D-printed group. Treatment adherence also tended to be higher in the 3D-printed group. No significant differences were observed in grip or pinch strength.

Conclusions: 3D-printed orthoses are an effective and promising option for conservative management of rhizarthrosis, with potential benefits in pain relief, patient satisfaction, and adherence compared with conventional custom-fitted orthoses.