Characterizing Hand Therapy Participation Following Trapeziectomy for Carpometacarpal Osteoarthritis

BACKGROUND: TSymptomatic thumb carpometacarpal arthritis refractory to nonoperative treatment often results in carpometacarpal arthroplasty surgery. Postoperative therapy facilitates functional recovery, but there may be barriers that can affect recovery and final outcomes. This study identified socioeconomic or functional factors influencing therapy attendance after surgery and patient outcomes. METHODS: Patients at a single academic institution from 2014 to 2024 with carpometacarpal osteoarthritis undergoing carpometacarpal arthroplasty surgery were reviewed. Demographics, postoperative clinic and therapy visits, Patient-Reported Outcomes Measurement Information System scores, and Quick Disabilities of the Arm, Shoulder, and Hand scores were tallied. Bivariate analysis compared patients attending 5 or more therapy sessions with those who did not. Area of deprivation was used to divide patients for analysis. RESULTS: A total of 1259 patients were eligible for inclusion, with 1078 (85.6%) attending hand therapy for 4 [2, 7] sessions over 7.4 [3.6, 12.1] weeks. Socioeconomically disadvantaged patients had fewer therapy visits but no worse functional outcomes. Patients engaging in consistent therapy reported worse pain interference, physical function, and upper extremity function at 6 weeks relative to those attending fewer sessions (all P < .05). Function nearly equalized at 3 months, and at 6 months, consistent therapy patients achieved more favorable Pain Interference and Physical Function scores (P < .05). CONCLUSION: Patients with carpometacarpal osteoarthritis exhibit high therapy attendance following surgery. Socioeconomically disadvantaged patients attended fewer therapy sessions but had comparable functional outcomes. Patients with poorer functional scores at 6 weeks tended to attend therapy longitudinally. At latest follow-up however, their function exceeded non-participants. Therapy attendance is influenced by socioeconomic factors and natural functional recovery.