CMC 1 total joint arthroplasty: rehabilitation or education? A controlled trial.

Joint wear of the thumb base or osteoarthritis of the first carpometacarpal (CMC1) joint is a common cause of pain and loss of function of the hand, especially in postmenopausal women. This can lead to severe reduction in quality of life due to limitations in activities of daily life. The prevalence of radiological arthrosis of the thumb base in people above 55 years of age is around 35%. The amount of scientific literature dealing with the application of a CMC1 total joint arthroplasty is very limited, moreover the post-operative approach hardly has been described. There are insufficient comparative studies of the additional value and effectiveness of postoperative hand therapy in thumb base osteoarthritis in general and, more specific, of CMC1 total joint arthroplasty. Aim of this study is to investigate whether postoperative rehabilitation with hand therapy after CMC1 total joint arthroplasty leads to better results than education only in the short term.

Supervised rehabilitation with hand therapy in the first three months after total joint arthroplasty is beneficial to education only, in improving functional outcome.

Preoperatively, 3 months and 1 year postoperatively

A historic cohort (resulting from a completed randomized clinical trial ) with standard care (supervised rehabilitation with hand therapy) will be compared with a prospective cohort of people who only received oral and written education about the surgery, the postoperative period and expected recovery process.