Trapeziectomy and Ligament Reconstruction for Osteoarthrosis of the Base of the Thumb

100 thumbs with primary osteoarthrosis of the joints of the trapezium were treated by trapeziectomy and a FCR sling arthroplasty to reconstruct a first intermetacarpal ligament by the method described by Burton and Pellegrini (1986). Pain at rest remained in five. Some pain at or after exertion persisted in 46, and 49 became completely pain-free. 88 were satisfied with the procedure and there was a significant increase in pinch strength and in the ability to perform activities of daily life. It has become our preferred procedure for treating osteoarthrosis of the basal joint of the thumb.

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Thumb-Basal Joint Arthroplasty Outcomes and Metacarpal Subsidence: A Prospective Cohort Analysis of Trapeziectomy With Suture Button Suspensionplasty Versus Ligament Reconstruction With Tendon Interposition

Hand ◽

10.1177/1558944721994227 ◽

2021 ◽

pp. 155894472199422

Author(s):

Owolabi Shonuga ◽

Kristen Nicholson ◽

Jack Abboudi ◽

Gregory Gallant ◽

Christopher Jones ◽

...

Keyword(s):

Ligament Reconstruction ◽

Demographic Data ◽

Cohort Analysis ◽

Joint Arthroplasty ◽

Pinch Strength ◽

Complication Rates ◽

Suture Button ◽

Basal Joint ◽

Tendon Interposition ◽

Cmc Joint

Background Thumb carpometacarpal (CMC) joint arthroplasty is a common procedure in the surgical management of symptomatic thumb basal joint arthritis. Following trapeziectomy, a number of suspensionplasty techniques are often used, but limited comparative evidence exists between these techniques. The central aim of this study was to prospectively compare the outcomes of 2 suspensionplasty techniques following trapeziectomy: suture button (TightRope) versus ligament reconstruction and tendon interposition (LRTI). Methods Prospective data were collected on 112 consecutive patients with Eaton stage III-IV thumb CMC arthritis who underwent open trapeziectomy and suspensionplasty. There were 53 LRTI and 59 TightRope suspensionplasty procedures. Outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand ( QuickDASH) questionnaire, Visual Analogue Scale (VAS) for pain, radiographic analysis, and lateral pinch strength. Patient demographic data and complications were also recorded. Results Patients undergoing TightRope suspensionplasty had significantly higher trapeziometacarpal index and thus less subsidence than the LRTI group at 2 weeks (0.22 vs 0.17 [ P < .0001]) and 3 months (0.17 vs 0.15 [ P < .05]) postoperatively. TightRope suspensionplasty also had a significantly lower QuickDASH score at 2 weeks (64.7 vs 74.6 [ P < .05]), 3 months (20.7 vs 32.5 [ P < .05]), and 1 year postoperatively (7.57 vs 21.5 [ P < .05]) compared with the LRTI group. However, there was no difference in VAS pain, lateral pinch strength, reoperation, or complications at any time point between groups. Conclusions Thumb CMC joint arthroplasty performed with a TightRope suspensionplasty versus LRTI yielded short-term improved resistance to subsidence, long-term greater improvement in clinical outcome by QuickDASH, and no difference in pain or complication rates.

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Changes in Key Pinch Strength after Excision of the Trapezium and Total Joint Arthroplasty

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2003.09.004 ◽

2004 ◽

Vol 29 (1) ◽

pp. 40-41 ◽

Cited By ~ 20

Author(s):

L. DE SMET ◽

W. SIOEN ◽

D. SPAEPEN

Keyword(s):

Total Joint Arthroplasty ◽

Ligament Reconstruction ◽

Joint Arthroplasty ◽

Pinch Strength ◽

Pinch Force ◽

Basal Joint ◽

Tendon Interposition ◽

Joint Arthritis

Key pinch force was measured preoperatively and at follow-up (mean 25 months) in patients treated for basal joint arthritis by either trapziectomy with ligament reconstruction and tendon interposition ( n=26) or total joint arthroplasty ( n=27). There was a significant increase in key pinch strength with both treatments, but no difference between the two treatments. Total joint arthroplasty does not appear to produce stronger key pinch than trapziectomy with ligament reconstruction and tendon interposition.

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Trapeziectomy and ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193413514500 ◽

2013 ◽

Vol 39 (8) ◽

pp. 833-837 ◽

Cited By ~ 12

Author(s):

R. Langenhan ◽

B. Hohendorff ◽

A. Probst

Keyword(s):

Analogue Scale ◽

Ligament Reconstruction ◽

Pinch Strength ◽

Dash Score ◽

Trapeziometacarpal Osteoarthritis ◽

Osteoarthritis Of The Wrist ◽

Pain At Rest ◽

Tendon Interposition ◽

Median Pain

Isolated osteoarthritis of the scaphotrapeziotrapezoid joint is rather rare compared with thumb trapeziometacarpal osteoarthritis. The aim of this retrospective study was to evaluate the outcome of 15 consecutive patients treated with trapeziectomy/ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist. After a mean follow-up of 54 months, 14 patients (15 wrists) were available for clinical and radiological examination. The median pain intensity was 0 on a 0–10 visual analogue scale, both at rest and with activity, mean grip strength averaged 24 kg, pinch strength 5 kg. The disabilities of the arm, shoulder and hand (DASH) score was 16, and a modified Mayo Wrist Score 84. Correlation between the degree of scaphotrapezoid osteoarthritis and pain at rest, pain with activity, and DASH score was not significant. The findings from our study suggest that trapeziectomy/ligament reconstruction tendon interposition is an effective procedure for treating isolated scaphotrapeziotrapezoid osteoarthritis, and that additional partial trapezoid excision is not necessary.

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Functional outcome of ligament reconstruction tendon interposition for basal joint arthritis of thumb

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171890 ◽

2017 ◽

Vol 3 (3) ◽

pp. 492

Author(s):

Saranjeet Singh Jagdev ◽

Subodh Kumar Pathak ◽

Nisheet Dave ◽

Abhijeet Salunke

Keyword(s):

Ligament Reconstruction ◽

Advanced Disease ◽

Pinch Strength ◽

Dash Score ◽

Care Hospital ◽

Strength Gain ◽

Basal Joint ◽

Tendon Interposition ◽

Joint Arthritis ◽

Cmc Joint

Background: Thumb carpometacarpal osteoarthritis is a common disease, affecting up to 11% and 53% of men and women in their 50s respectively, which leads to pain, stiffness, weakness of the CMC joint. Patients with advanced disease have multiple surgical options including ligament reconstruction with tendon interposition, resection arthroplasty, silicone implantation, or total joint arthroplasty. The aim of study was to evaluate results of LRTI for CMC joint arthritis. Methods: This is a series of 29 patients operated in a tertiary care hospital. All patients included in the study were seen in the outpatient and identified to have basal joint arthritis according to their clinical presentation and classified on the basis of radiologic appearance. Trapeziectomy with ligament reconstruction with tendon interposition was done for patients with advanced disease. All the patients were followed up and assessed for function and disability using DASH score.Results: Average duration of follow up was 36 months with average tip pinch strength gain was 75%, key pinch strength gain 80% , grip strength gain 80 % of other limb. Significant Improvement in active 1st web space angle was seen with average of 19.5 degree. Average DASH score was 4.14. Nobody had extreme pain, 3 had mild pain and 2 had moderate pain. Conclusions: Based on our observation of DASH scores, the results have remained encouraging in most of the cases with restoration of normal anatomy to provide a stable and functional thumb. The success of LRTI in treating trapeziometacarpal arthritis has withstood the test of time.

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The effect of exercise on quality of life and activities of daily life in frail older adults: A systematic review of randomised control trials

Experimental Gerontology ◽

10.1016/j.exger.2021.111287 ◽

2021 ◽

Vol 147 ◽

pp. 111287

Author(s):

Evan Campbell ◽

Fanny Petermann-Rocha ◽

Paul Welsh ◽

Carlos Celis-Morales ◽

Jill P. Pell ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Daily Life ◽

Frail Older Adults ◽

Activities Of Daily Life ◽

Randomised Control Trials

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Ligament Reconstruction Basal Joint Arthroplasty Without Tendon Interposition

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199709000-00008 ◽

1997 ◽

Vol 342 ◽

pp. 42???45 ◽

Cited By ~ 45

Author(s):

Michelle Gerwin ◽

Annabel Griffith ◽

Andrew J. Weiland ◽

Robert N. Hotchkiss ◽

Richard R. McCormack

Keyword(s):

Ligament Reconstruction ◽

Joint Arthroplasty ◽

Basal Joint ◽

Tendon Interposition

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Comparison of body-powered voluntary opening and voluntary closing prehensor for activities of daily life

The Journal of Rehabilitation Research and Development ◽

10.1682/jrrd.2013.05.0123 ◽

2014 ◽

Vol 51 (2) ◽

pp. 253-262 ◽

Cited By ~ 11

Author(s):

Kelsey Berning ◽

Sarah Cohick ◽

Reva Johnson ◽

Laura Ann Miller ◽

Jonathon W. Sensinger ◽

...

Keyword(s):

Daily Life ◽

Activities Of Daily Life

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Effectiveness of Triamcinolone Hexacetonide Intraarticular Injection in Interphalangeal Joints: A 12-week Randomized Controlled Trial in Patients with Hand Osteoarthritis

The Journal of Rheumatology ◽

10.3899/jrheum.140736 ◽

2015 ◽

Vol 42 (10) ◽

pp. 1869-1877 ◽

Cited By ~ 14

Author(s):

Natalia de Oliva Spolidoro Paschoal ◽

Jamil Natour ◽

Flavia S. Machado ◽

Hilda Alcântara Veiga de Oliveira ◽

Rita Nely Vilar Furtado

Keyword(s):

Adverse Effects ◽

Repeated Measures ◽

Controlled Trial ◽

Hand Function ◽

Intraarticular Injection ◽

Pinch Strength ◽

Hand Osteoarthritis ◽

Triamcinolone Hexacetonide ◽

Link Type ◽

Pain At Rest

Objective.To evaluate the effectiveness and tolerance of intraarticular injection (IAI) of triamcinolone hexacetonide (TH) for the treatment of osteoarthritis (OA) of hand interphalangeal (IP) joints.Methods.Sixty patients who underwent IAI at the most symptomatic IP joint were randomly assigned to receive TH/lidocaine (LD; n = 30) with TH 20 mg/ml and LD 2%, or just LD (n = 30). The injected joint was immobilized with a splint for 48 h in both groups. Patients were assessed at baseline and at 1, 4, 8, and 12 weeks by a blinded observer. The following variables were assessed: pain at rest [visual analog scale (VAS)r], pain at movement (VASm), swelling (physician VASs), goniometry, grip and pinch strength, hand function, treatment improvement, daily requirement of paracetamol, and local adverse effects. The proposed treatment (IAI with TH/LD) was successful if statistical improvement (p < 0.05) was achieved in at least 2 of 3 VAS. Repeated-measures ANOVA test was used to analyze intervention response.Results.Fifty-eight patients (96.67%) were women, and the mean age was 60.7 years (± 8.2). The TH/LD group showed greater improvement than the LD group for VASm (p = 0.014) and physician VASs (p = 0.022) from the first week until the end of the study. In other variables, there was no statistical difference between groups. No significant adverse effects were observed.Conclusion.The IAI with TH/LD has been shown to be more effective than the IAI with LD for pain on movement and joint swelling in patients with OA of the IP joints. Regarding pain at rest, there was no difference between groups. Trial registration number: ClinicalTrials.gov (NCT02102620).

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