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How Accurate and Effective Are Non-image-guided Thumb Basal Joint Injections When Performed by Experienced
Gerardo E Sanchez-Navarro1, Madeline C Rocks, Omri Ayalon
1Department of Orthopedic Surgery, Division of Hand Surgery, NYU Langone Health, New York, NY, USA.
Clinical Orthopaedics and Related Research
|December 1, 2024
Summary
Corticosteroid injections for thumb arthritis are effective without imaging guidance, with 79% accurately placed intraarticularly. This provided significant short-term pain relief and improved function for patients.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Medicine
- Pain Management
Background:
- Corticosteroid injections are a common treatment for thumb carpometacarpal (CMC) arthritis.
- Accuracy of non-image-guided injections by expert hand surgeons remains uncertain.
- Prior studies show variable intraarticular placement rates.
Purpose of the Study:
- To determine the accuracy of non-image-guided corticosteroid injections in the thumb CMC joint by fellowship-trained hand surgeons.
- To evaluate the short-term clinical efficacy of these injections.
Main Methods:
- Prospective enrollment of 33 patients with persistent thumb CMC arthritis symptoms.
- Administration of 1.5-mL corticosteroid injections without image guidance.
- Assessment of outcomes using VAS, QuickDASH, and TDX scores at 6 weeks.
Main Results:
- 79% of injections were accurately placed intraarticularly.
- Significant improvements were observed in QuickDASH (22 points), TDX (24 points), and VAS (4 points) scores at 6 weeks.
- 73-82% of patients achieved minimum clinically important differences in patient-reported outcomes.
Conclusions:
- Non-image-guided corticosteroid injections by experienced hand surgeons achieve high intraarticular accuracy.
- These injections provide meaningful short-term pain relief and functional improvement for thumb CMC arthritis.
- Non-image-guided injections are a viable treatment option, warranting further investigation into long-term outcomes and adjunctive therapies.
