Arthritis of the base of the thumb is a common debilitating problem. It is believed that
laxity (loosening) of the joint leads to worsening arthritis in this joint. This can be
treated by securing the joint surgically or symptoms can be treated with hand therapy and/or
injection of corticosteroids. Recently prolotherapy (sugar water) has been shown to
decrease looseness of joints and also be helpful for hand and knee arthritis. We
hypothesize that prolotherapy injections for thumb arthritis will be equally or more
beneficial to the patients then steroids.
This will be a prospective randomized double blind comparison study comparing Celestone to
Dextrose intra-articular injections as adjuncts to hand therapy for the treatment of
symptomatic thumb CMC osteoarthritis. Twenty patients will be randomized to each treatment
arm to provide enough power to show a 20% change in visual analogue scale (VAS) for pain to
be significant. We will also be measuring analgesic use, various grip strength and upper
extremity functional assessment scores.
- Age >45
- ability to make follow-up visits over the 6 month protocol
- ability to give informed consent
- Eaton Grad thumb carpo-metacarpal joint osteoarthritis with pain over 3/10 on visual
analogue scale with symptoms present greater then 6 months.
- Recent trauma to the hand or wrist or fractures eeen on radiographs
- Eaton grade 1 or 4 joints, metabolic bone disease, recent systemic or localized
infection (within last 2 weeks)
- history of rheumatologic disease
- allergies to injected solutions
- thumb carpo-metacarpal joint injections in the prior 6 months.