The effectiveness of Wharton’s jelly versus steroid injection for the treatment of thumb carpometacarpal joint arthritis for pain relief and the increase of function
Main Article Content
Abstract
We compared the effectiveness of Wharton’s jelly versus steroid injection into the carpometacarpophalangeal joint by comparing 60 patients in two cohorts with a follow up evaluation at three months and then at one year. We evaluated preoperative and postoperative grip strength, pinch strength, thumb range of motion, Disabilities of Arm, Shoulder, and Hand (DASH) score and a Visual Analog (VAS) pain score before the injection and then at 3 months and 12 months after injection. The patients in the steroid injection group had substantial improvement in their DASH and VAS pain scores as well as their pinch strength at 3 months p < .05. However, by the 12-month evaluation the benefits of the steroid injection had completely dissipated. The patients in the Wharton’s jelly cohort had improvements at 3 months in terms DASH and VAS score and pinch strength and this improvement persisted at the one-year evaluation. However, grip strength and thumb range of motion did not substantially improve in either group.
Keywords:
arthritis, joint arthritis, Wharton’s jelly versus steroid injection, thumb carpometacarpal
Article Details
How to Cite
LOFINK, Spencer; TRUMBLE, Thomas.
The effectiveness of Wharton’s jelly versus steroid injection for the treatment of thumb carpometacarpal joint arthritis for pain relief and the increase of function.
Medical Research Archives, [S.l.], v. 11, n. 11, jan. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4699>. Date accessed: 16 may 2024.
doi: https://doi.org/10.18103/mra.v11i11.4699.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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24. Phan A, Calderon T, Hammert WC. Evaluation of PROMIS Scores 6 Weeks after Conservative Management of Carpometacarpal Thumb Arthritis. Plast Reconstr Surg Glob Open. 2022;10(10):e4493.
25. Gupta A, Rodriguez HC, Potty AG, Levy HJ, El-Amin Iii SF. Treatment of Knee Osteoarthritis with Intraarticular Umbilical Cord-Derived Wharton's Jelly: A Case Report. Pharmaceuticals (Basel). 2021;14(9).
26. Gupta A, El-Amin SF, 3rd, Levy HJ, Sze-Tu R, Ibim SE, Maffulli N. Umbilical cord-derived Wharton's jelly for regenerative medicine applications. J Orthop Surg Res. 2020;15(1):49.
27. Cocchiarella LA, G.B.J. Upper Extremity Impairment Evaluation. In: Cocchiarella LA, G.B.J., editor. Guidelines to the Evaluation of Permanent Impairment. 5th ed. United States: AMA Press; 2000. p. 437-510.
2. Vermeulen GM, Slijper H, Feitz R, Hovius SE, Moojen TM, Selles RW. Surgical management of primary thumb carpometacarpal osteoarthritis: a systematic review. J Hand Surg Am. 2011;36(1):157-69.
3. Day CS, Gelberman R, Patel AA, Vogt MT, Ditsios K, Boyer MI. Basal joint osteoarthritis of the thumb: a prospective trial of steroid injection and splinting. J Hand Surg Am. 2004;29(2):247-51.
4. Weiss AC, Goodman AD. Thumb Basal Joint Arthritis. J Am Acad Orthop Surg. 2018;26(16):562-71.
5. Arasegawa Y, Muramatsu K, Inoue K, Ueda T, Jyouichi K, Kinoshita D. The Relationship of Patient Characteristics and Prolonged Pain after Treatment of Carpometacarpal Joint Arthritis of the Thumb. J Hand Surg Asian Pac Vol. 2023;28(1):53-60.
6. Arrigoni C, D'Arrigo D, Rossella V, Candrian C, Albertini V, Moretti M. Umbilical Cord MSCs and Their Secretome in the Therapy of Arthritic Diseases: A Research and Industrial Perspective. Cells. 2020;9(6).
7. Challoumas D, Murray E, Ng N, Putti A, Millar N. A Meta-analysis of Surgical Interventions for Base of Thumb Arthritis. J Wrist Surg. 2022;11(6):550-60.
8. Chen X, Sun L, Wang S, Wang Y, Zhou Y, Li Y, et al. Effects of Prunus Tomentosa Thumb Total Flavones on adjuvant arthritis in rats and regulation of autophagy. Technol Health Care. 2023;31(S1):123-36.
9. Clarke S, Hagberg W, Kaufmann RA, Grand A, Wollstein R. Complications with the use of Artelon in thumb CMC joint arthritis. Hand (N Y). 2011;6(3):282-6.
10. de Villeneuve Bargemon JB, Jaloux C, Dobelle E, Plomion M. Comment on Tanaka et al. :Suspension arthroplasty using the palmaris longus tendon with a suture button for thumb trapeziometacarpal arthritis: A retrospective observational study. J Orthop Sci. 2023;28(4):949-50.
11. Fontes D. Basal joint arthroscopy indications in first CMC joint arthritis. Hand Surg Rehabil. 2021;40S:S117-S25.
12. Gander B, Wollstein R. Surgical Treatment for Thumb CMC Joint Arthritis. Curr Rheumatol Rev. 2013;9(2):113-8.
13. Gehrmann SV, Tang J, Li ZM, Goitz RJ, Windolf J, Kaufmann RA. Motion deficit of the thumb in CMC joint arthritis. J Hand Surg Am. 2010;35(9):1449-53.
14. Giddins G. Outcome of three very different treatments for thumb CMC joint arthritis. J Hand Surg Eur Vol. 2013;38(8):821.
15. Heineman JT, Forster GL, Stephens KL, Cottler PS, Timko MP, DeGeorge BR, Jr. A Randomized Controlled Trial of Topical Cannabidiol for the Treatment of Thumb Basal Joint Arthritis. J Hand Surg Am. 2022; 47 (7):611-20.
16. Hustedt JW, Deeyor ST, Hui CH, Vohra A, Llanes AC, Silvestri BL. A Prospective Clinical Trial Comparing Denervation With Suspension Arthroplasty for Treatment of Carpometacarpal Arthritis of the Thumb. J Hand Surg Am. 2023;48(4):348-53.
17. Kannan S, Viswanathan P, Gupta PK, Kolkundkar UK. Characteristics of Pooled Wharton's Jelly Mesenchymal Stromal Cells (WJ-MSCs) and their Potential Role in Rheumatoid Arthritis Treatment. Stem Cell Rev Rep. 2022;18(5):1851-64.
18. Laronde P, Duriez P, Oca V, d'Almeida MA, Hustin C. Thumb basal joint arthritis: New classification, diagnostic and therapeutic algorithm. Hand Surg Rehabil. 2022;41 (4):419-25.
19. Loibl M, Lang S, Dendl LM, Nerlich M, Angele P, Gehmert S, et al. Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study. Biomed Res Int. 2016;2016:9262909.
20. Luria S, Waitayawinyu T, Nemechek N, Huber P, Tencer AF, Trumble TE. Biomechanic analysis of trapeziectomy, ligament reconstruction with tendon interposition, and tie-in trapezium implant arthroplasty for thumb carpometacarpal arthritis: a cadaver study. J Hand Surg Am. 2007;32(5):697-706.
21. Maarse W, Watts AC, Bain GI. Medium-term outcome following intra-articular corticosteroid injection in first CMC joint arthritis using fluoroscopy. Hand Surg. 2009;14(2-3):99-104.
22. Matsuo T, Suzuki T, Hayakawa K, Kimura H, Matsumura N, Iwamoto T. Comparative study on the effectiveness of bone grafting for arthrodesis of the thumb carpometacarpal arthritis. J Hand Surg Eur Vol. 2023;48(4):309-15.
23. Passiatore M, Taccardo G, Cilli V, Rovere G, Liuzza F, Pannuto L, et al. Surgical treatment of carpometacarpal thumb arthritis with trapeziectomy and intra-tendon (FCR) suspension with one-loop APL: comparative cohort study. BMC Musculoskelet Disord. 2023;24(1):328.
24. Phan A, Calderon T, Hammert WC. Evaluation of PROMIS Scores 6 Weeks after Conservative Management of Carpometacarpal Thumb Arthritis. Plast Reconstr Surg Glob Open. 2022;10(10):e4493.
25. Gupta A, Rodriguez HC, Potty AG, Levy HJ, El-Amin Iii SF. Treatment of Knee Osteoarthritis with Intraarticular Umbilical Cord-Derived Wharton's Jelly: A Case Report. Pharmaceuticals (Basel). 2021;14(9).
26. Gupta A, El-Amin SF, 3rd, Levy HJ, Sze-Tu R, Ibim SE, Maffulli N. Umbilical cord-derived Wharton's jelly for regenerative medicine applications. J Orthop Surg Res. 2020;15(1):49.
27. Cocchiarella LA, G.B.J. Upper Extremity Impairment Evaluation. In: Cocchiarella LA, G.B.J., editor. Guidelines to the Evaluation of Permanent Impairment. 5th ed. United States: AMA Press; 2000. p. 437-510.