Osteophyte Growth Over 10 Years in the Fingers of High-Level Climbers and Contributing Factors.

Although osteophytes in climbers' fingers are known as part of a mechano-adaption, the progression of osteophytes and contributing factors during an advanced elite climber's career is still unknown. This study analyzes osteophyte growth over 10 years for each phalangeal head and base of all proximal and distal interphalangeal joints (PIP and DIP) individually as well as the impact of potential climbing related influencing factors. Furthermore, the osteophytes located at the palmar neck of the proximal phalanx (palmar neck osteophytes) were investigated separately and joint space narrowing was evaluated and compared with osteophyte growth. Radiographs of 31 male elite climbers were analyzed in lateral view for osteophytes and in anterior-posterior (a.p.) view for joint space at baseline and 10-year follow-up. Even after more than 2 decades of elite climbing, osteophytes grew significantly at most phalangeal heads and bases. Already severely affected joints at baseline, specifically DIP Dig III and IV of both hands, had an especially high effect size (DIP base: Dig III: left; 0.517, right; 0.355, Dig IV: left; 0.519, right; 0.555, DIP head: Dig III: left; 0.348, right; 0.591, Dig IV: left; 0.533, right; 0.408). The extent of osteophytes at baseline is highly predictive for further development (79.3%); however, no climbing-related factors were determinable for additional explanation. Palmar neck osteophytes are pathognomonic to climbing as they are most likely caused by the phalangeal base hitting this area repeatedly in a hyperflexed position. Furthermore, there is no correlation between osteophyte growth and joint space narrowing during an elite climber's career.