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The purpose was to determine revision rates after trapeziometacarpal total joint arthroplasty in working age patients, hypothesizing that higher occupational hand force requirements lead to higher revision rates. We conducted a follow-up study of patients operated 2003-2015. Self-reported job titles at the time of primary surgery were linked with a job exposure matrix to estimate occupational hand force requirements. Time until revision was analysed using Cox regression. The study comprised 222 patients aged 39-65 years (mean 55, SD 6), including 133 patients in the labour market. The median follow-up period was 5 years (interquartile range 4-7) and the overall revision rate was 5/100 person-years. For high versus low occupational hand force requirements, the hazard ratio was 1.5 (95% confidence interval 0.5-4.4). For patients outside the labour market, the hazard ratio was 2.3 (0.9-5.6). Our results did not indicate large effects of high occupational hand force requirements on revision rates.

Objectives To evaluate if higher cumulative occupational hand force requirements are associated with higher risks of surgery for trapeziometacarpal osteoarthritis and with surgery earlier in life. Methods The study was based on Danish national registers. Among all persons born in Denmark 1931 to 1990, we included those who had been employed for at least 5 years since 1991 by the end of 2000, or later when this employment criterion was reached, up until the end of 2016. Cumulative exposure estimates for 10-year time windows (force-years) were assessed by combining individual year-by-year information on occupational codes with an expert based hand-arm job exposure matrix. First-time events of surgery for trapeziometacarpal osteoarthritis 2001 to 2017 constituted the outcome. Surgery rates were analysed by a logistic regression technique equivalent to discrete survival analysis using a 1-year lag. We also calculated rate advancement periods. Results A total of 2 860 448 persons contributed with around 48 million person-years of follow-up, during which 3977 cases appeared (821 among men and 3156 among women). Compared with <5 force-years, the adjusted OR (OR adj) for ≥5 to <10 force-years was 1.39 (95% CI 1.14 to 1.68) and for ≥10 to 30 force-years 1.47 (95% CI 1.26 to 1.71) among men and 1.64 (95% CI 1.50 to 1.78) and 1.29 (95% CI 1.16 to 1.43) among women. The sex combined OR adj were 1.59 (95% CI 1.47 to 1.72) and 1.36 (95% CI 1.25 to 1.48). Among the exposed, surgery was advanced by 3 to 7 years. Conclusion Medium/high cumulative hand force requirements were associated with elevated hazard rates of surgery for trapeziometacarpal osteoarthritis and advanced the time of surgery by several years.

Objective:Evaluate incidence rates (IRs) of carpal tunnel syndrome (CTS) as sentinels to identify job groups with high hand-wrist exposures.Methods:A nationwide register-based cohort study of all born in Denmark. During follow-up 2010 to 2013, we identified first-time CTS diagnoses. We established job groups, calculated sex-specific age-standardized IRs (SIRs) per job group. We linked occupational codes with a job exposure matrix, calculated mean hand load estimate per job group, and plotted hand load against the SIRs.Results:We followed 1,171,580 men and 1,137,854 women for 4,046,851 and 3,994,987 person-years; identified 4405 cases among men, 7858 among women; obtained crude IRs of 10.9 and 19.7 per 10,000 person-years. For both sexes, there was a positive association between SIRs and hand load.Conclusions:Higher SIRs pointed to job groups with higher hand load. Elevated SIRs of CTS may serve as sentinels of harmful hand activities.