Usefulness of custom-made orthoses with 3D scanning and printing for the conservative treatment of rhizarthrosis.

Abstract

Trapeziometacarpal osteoarthritis (rhizarthrosis) is often managed with orthopedic orthoses that are prefabricated in various sizes and may be manipulated to be adapted to the patient's anatomy. Advances in three-dimensional scanning and printing now allow fabrication of anatomically matched custom-made orthoses. To assess the feasibility and effectiveness of a 3D-printed orthosis compared with custom-fitted orthoses in the conservative treatment of rhizarthrosis. Feasibility randomized controlled study. Thirty-nine patients (42 hands) without prior treatment were randomized into 2 groups: custom-fitted orthoses (n = 21 hands) and 3D-printed orthoses (n = 21 hands). Data on sociodemographic characteristics, pain (measured by visual analog scale), grip and pinch strength (using a dynamometer), and functional outcomes (DASH score) were collected at baseline, 1 month, and 3 months. Treatment adherence and patient satisfaction were also evaluated. Pain levels decreased in both groups, with a more pronounced improvement in the 3D-printed group at 1 month (between-group difference -1.14, 95% CI -2.25 to -0.33, p < 0.05). Patients using 3D-printed orthoses also reported higher satisfaction (45.0 ± 6.97 vs 35.5 ± 9.36, p < 0.001). Both groups showed improvements in DASH scores, with greater gains in the 3D-printed group. Treatment adherence also tended to be higher in the 3D-printed group. No significant differences were observed in grip or pinch strength. 3D-printed orthoses are an effective and promising option for conservative management of rhizarthrosis, with potential benefits in pain relief, patient satisfaction, and adherence compared with conventional custom-fitted orthoses.