早期腕骨关节炎的进展、疼痛和功能：一项为期六年的纵向研究

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-07-22 DOI:10.1016/j.jhsg.2025.100795

Peter T. Ajayi BA , Amy M. Morton MSc , Amy L. Ladd MD , Arnold-Peter C. Weiss MD , Joseph J. Crisco PhD

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引用次数: 0

摘要

目的本研究的目的是检查早期腕骨关节炎（OA）患者和健康对照者6年改良Eaton分期、疼痛评分和手部力量的进展，说明OA组和对照组之间的差异。采用三维计算机断层成像技术将骨性关节炎患者分为稳定组和进展组，以识别临床和影像学标志物，将进展性骨性关节炎与稳定疾病和健康对照区分开来。方法收集86例早期掌骨关节炎患者的数据，这些患者根据横骨体积（进展定义为每次就诊时150 mm3或生长速度14.6 mm3/年）分为稳定型或进展型OA，并从22名健康对照中收集数据。骨关节炎患者在基线和1.5年的间隔进行评估，直至6年，而对照组在基线和第6年进行评估。我们分析了6年来各组的改良Eaton分期、患者评定的腕/手评估、澳大利亚/加拿大OA手指数疼痛和功能评分以及关键捏握强度。Tukey诚实显著差异检验评估组间差异，固定效应模型评估时间和OA进展对结果的影响，统计学意义设置为P <；. 05。结果进展性OA患者的改良Eaton评分增加，到第6年有明显的进展。在基线和第6年，稳定组和进展组的患者腕/手评估和澳大利亚/加拿大OA手指数疼痛评分均高于对照组(P <；.05)，但稳定型和进展型OA之间的差异极小。OA组的功能评分同样较高，而关键捏握力量随时间的变化趋势不大，稳定型和进展型OA之间差异不大。结论改良Eaton评分的影像学差异可区分进展性骨关节炎和稳定性骨关节炎，表明结构进展是疾病进展的关键标志。骨性关节炎组之间疼痛、功能评分和手部力量的微小差异表明，放射学变化比主观或客观功能测量更能明确骨性关节炎进展的指标。这些发现强调影像学监测是骨性关节炎进展的主要参数。研究类型/证据水平预后

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Osteoarthritis Progression, Pain, and Function in Early Carpometacarpal Osteoarthritis: A Six-Year Longitudinal Study

Purpose

The purpose of this study was to examine the 6-year progression of modified Eaton staging, pain scores, and hand strength in patients with early carpometacarpal osteoarthritis (OA) and healthy controls, illustrating the differences between OA groups and controls. Osteoarthritis patients were stratified into stable and progressing groups using three-dimensional computed tomography imaging to identify clinical and radiographic markers differentiating progressing OA from stable disease and healthy controls.

Methods

Data were collected from 86 early carpometacarpal OA patients, classified as stable or progressing OA based on trapezial osteophyte volume (progression defined as >150 mm³ at any visit or a growth rate >14.6 mm³/y), and from 22 healthy controls. Osteoarthritis patients were assessed at baseline and at 1.5-year intervals up to 6 years, whereas controls were evaluated at baseline and year 6. We analyzed modified Eaton stage, patient-rated wrist/hand evaluation, Australian/Canadian OA hand index pain and function scores, and key pinch and grip strengths across groups over 6 years. Tukey honestly significant difference tests evaluated intergroup differences, and fixed effects models assessed the effects of time and OA progression on outcomes, with statistical significance set at P < .05.

Results

Progressing OA demonstrated an increase in modified Eaton score, with clear progression by year 6. Patient-rated wrist/hand evaluation and Australian/Canadian OA hand index pain scores were elevated in both stable and progressing OA groups at baseline and year 6 compared with controls (P < .05), although minimal differences existed between stable and progressing OA. Functional scores were similarly higher in OA groups, whereas key pinch and grip strength showed little trend over time, with minor differences between stable and progressing OA.

Conclusions

Marked radiographic differences in modified Eaton score distinguish progressing from stable OA, indicating that structural progression is a key marker of disease advancement. Minimal differences in pain, functional scores, and hand strength between OA groups suggest that radiographic changes are more distinct indicators of OA progression than subjective or objective functional measures. These findings emphasize radiographic monitoring as the major parameter for OA progression.