Video-Only Noninferior to In-Person Therapy After Thumb Carpometacarpal Arthroplasty

May 03, 2024

THURSDAY, May 2, 2024 (HealthDay News) — For upper-extremity function after thumb carpometacarpal (CMC) arthroplasty, video-only therapy (VOT) is noninferior to in-person therapy (IPT), according to a study published in the April 17 issue of the Journal of Bone & Joint Surgery.

Patrick C. Barrett, M.D., from the Virginia Tech Carilion School of Medicine in Roanoke, and colleagues performed a single-site, prospective, randomized controlled trial involving 50 female and eight male patients undergoing primary thumb CMC arthroplasty without an implant. The Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) score was the primary outcome measure. Patients in the VOT group were provided with three videos of home exercises to perform, while those in the control group received standardized IPT with a hand therapist.

Overall, 58 participants were included in the analysis at the 12-week time point and 54 were included at the one-year time point. The researchers found that for the PROMIS UE score, VOT was noninferior to IPT at 12 weeks and one year postoperatively, with a difference of mean improvement of 1.5 and 2.2, respectively, which were both below the minimal clinically important difference of 4.1. On average, the VOT group potentially saved 201.3 miles in travel.

“This trial yields evidence that a more patient-driven approach with provision of videos is an acceptable alternative to traditional IPT after thumb CMC arthroplasty and has the added benefit of reducing the potential travel burden for patients,” the authors write.

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