Practice patterns following carpometacarpal (CMC) arthroplasty.

ABSTRACT

STUDY DESIGN: Descriptive Survey. INTRODUCTION: Therapy following thumb carpometacarpal (CMC) arthroplasty is a complex issue as there are multiple surgical procedures and postoperative rehabilitative programs. PURPOSE OF THE STUDY To gather information from therapy practitioners on practice patterns following thumb carpometacarpal (CMC) joint arthroplasty. METHODS: A web-based survey was sent to 3221 occupational and physical therapists in a single stage via online technology. RESULTS: Six-hundred and one (601) therapists responded to the survey. Key findings included Most therapists (45.5%) indicated that the therapy program they use was developed in collaboration with the referring surgeon. In addition, most patients received a plaster splint or long thumb spica orthosis following surgery, but time frames for use varied widely. Fifty-five percent of respondents waited until after 22 days postsurgery to initiate active flexion/extension of the wrist, while 19.5% initiated wrist flexion/extension between eight and 14 days postsurgery. Ten percent of respondents initiated active thumb flexion/extension within the first postoperative week, while 55% of respondents did not initiate thumb motion until 22 or more days following surgery. Few respondents (5.7%) indicated that they used a published evidence-based treatment program to guide therapy following thumb CMC arthroplasty surgery. CONCLUSION: This study demonstrates that multiple therapy programs exist and rehabilitation following thumb CMC arthroplasty predominantly utilizes clinical expertise.