Assessment of Pain After Intra-articular Botulinum Toxin Injections in Carpometacarpal Osteoarthritis of the Thumb

Inclusion criteria

• Patient >18 years old
• Patient with rhizarthrosis objectified by interrogation, radiography with at least 2 of the following criteria: osteophyte, joint space narrowing, subchondral sclerosis or geode
• Patient who has had an X-ray of the wrist (face, profile and Kapandji incidence) to estimate the severity of the rhizarthrosis.
• Patient with signed informed consent.
• Visual analog scale (VAS) of pain > 4
• Failure of well-conducted drug treatments with level 1 and 2 analgesics, anti-inflammatory drugs and orthotic devices
• Patients must have stopped all corticosteroid or non-steroidal anti-inflammatory drugs therapy within the last 48 hours.
• Patient affiliated with a Social Security plan
• Patient who can understand the study instructions
• Patient on effective contraception for more than one month according to the marketing authorization (Pill, intrauterine device, vaginal ring, contraceptive skin patch, hormonal subcutaneous implant)
• Infertile patients in connection with surgery (tubal ligation, oophorectomy, adnexectomy, hysterectomy)

Exclusion criteria

• History of surgery of the thumb column
• Patient who has received an intra-articular trapezoidal metacarpal injection of corticoids, botulinum toxin or hyaluronic acid or other product within the last 6 months.
• Patient who has received a Botulinum toxin injection at any site within the last 3 months
• Myasthenia or Lambert-Eaton disease, neuromuscular dysfunction, hypersensitivity to incobotulinumtoxin A, severe respiratory disorder or severe swallowing disorder
• Patients with hypersensitivity to botulinum toxin or to any of the excipients (human albumin sucrose)
• Patient with an infection or inflammation at the injection site concerned
• Pregnant or breastfeeding women (a urine pregnancy test will be performed)
• Patients with chronic inflammatory joint disease or microcrystalline pathology
• Current participation or less than 30 days of participation in a clinical drug trial
• Any medical or psychiatric condition that could prevent the proper understanding and conduct of the treatment and study (adult under guardianship)
• Patient who wishes to discontinue contraception during the study
• Patients at high risk of bleeding complications from the intra-articular injection (hemophilia, anticoagulant treatment, etc.)