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

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.

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.

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.

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.

Prognostic III.