Excision of the Trapezium and Interposition Arthroplasty with Gelfoam for the Treatment of Trapeziometacarpal Osteoarthritis

2003 ◽  
Vol 28 (3) ◽  
pp. 242-245 ◽  
Author(s):  
I. NUSEM ◽  
D. R. GOODWIN
Keyword(s):  
Grip Strength ◽  
Index Finger ◽  
Pinch Strength ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Postoperative Result ◽  
Trapeziometacarpal Osteoarthritis ◽  
Improved Function ◽  
Space Ratio

Excision of the trapezium with Gelfoam interposition was performed in 35 thumbs, 34 of which were evaluated after an average 5 years. Twenty-four patients had unilateral procedures. The follow-up examination included a standardized questionnaire and clinical and radiological examinations. Pain relief was achieved in all cases. The patients considered that 32 of their operated hands had improved function, while two had not improved. All patients were satisfied with the final postoperative result. Adduction of the thumb to the index finger, and opposition to the tip of the little finger was possible in all cases. Weakness, in comparison to the other thumb, of lateral pinch (71%; P=0.0001), tip pinch (74%; P=0.007), and grip strength (85%; P=0.006) were observed. The first web span was preserved in all hands. Calculation of the trapezial space ratio demonstrated only slight, insignificant shortening (7%; P=0.06) of the thumb ray. No significant correlations between the postoperative trapezial space ratio and lateral pinch strength, tip pinch strength, and grip strength were observed. We conclude that excision of the trapezium and Gelfoam interposition has no specific complications and is a reliable surgical treatment for osteoarthritis of the trapeziometacarpal joint.

Functional Outcome Following Salvage of Failed Trapeziometacarpal Joint Arthroplasty

2002 ◽  
Vol 27 (1) ◽  
pp. 96-100 ◽  
Author(s):  
K. J. RENFREE ◽  
P. C. DELL
Keyword(s):  
Pain Relief ◽  
Functional Outcome ◽  
Revision Surgery ◽  
Complication Rate ◽  
Joint Arthroplasty ◽  
Pinch Strength ◽  
Subjective Outcome ◽  
Trapeziometacarpal Joint ◽  
Improved Function

The outcomes in 12 patients who underwent revision surgery for a failed trapeziometacarpal joint arthroplasty were assessed. Multiple procedures were common (an average of 4.5 per patient), and associated with an overall complication rate of 27%. However, after an average follow-up of 5 years, nine of the 12 patients reported improved function and ability to complete normal daily tasks. Most patients were satisfied with their level of pain relief, their grip and pinch strength, and their overall final result. The subjective outcome was less satisfactory in those involved in workers’ compensation litigation. All seven attempted scaphoid–thumb metacarpal fusions failed.

FIVE TO EIGHT YEARS FOLLOW-UP FOR TRAPEZIECTOMY AND WEILBY LIGAMENT RECONSTRUCTION FOR THE TREATMENT OF TRAPEZIOMETACARPAL OSTEOARTHRITIS

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 369-373 ◽  
Author(s):  
A. S. C. Bidwai ◽  
W. J. Marlow ◽  
Y. Khan ◽  
M. Waseem
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Ligament Reconstruction ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Post Surgery ◽  
Trapeziometacarpal Osteoarthritis ◽  
And Function

Trapeziectomy and Weilby ligament reconstruction is a recognized treatment for osteoarthritis of the trapeziometacarpal joint. Studies published using this procedure have limited follow-up post-surgery. In this series of 24 cases assessed objectively and 36 subjectively with a minimum follow-up of five years, patients continue to have pain relief and function comparable to the opposite non-operated hand. Patient satisfaction is high at 92% and the rate of complications is low. Despite these encouraging results the need for interposition arthroplasty and/or ligament reconstruction in addition to trapeziectomy alone is discussed.

The Moovis® implant for trapeziometacarpal osteoarthritis: results after 2 to 6 years

2020 ◽  
Vol 45 (5) ◽  
pp. 477-482 ◽  
Author(s):  
Antoine Martins ◽  
Sébastien Charbonnel ◽  
Frédéric Lecomte ◽  
Lionel Athlani
Keyword(s):  
Analogue Scale ◽  
Pinch Strength ◽  
Trapeziometacarpal Joint ◽  
Level Of Evidence ◽  
Dual Mobility ◽  
Joint Replacements ◽  
Trapeziometacarpal Osteoarthritis ◽  
Contralateral Hand ◽  
Thumb Motion

In this retrospective study we reviewed the outcomes of 46 trapeziometacarpal joint replacements with the Moovis® prosthesis in 46 patients with painful osteoarthritis. The dual mobility design of this prosthesis aims to reduce prosthetic dislocation and subsidence. At follow-up 2 to 6 years (mean 5 years) after operation, pain was reduced from 6 to 0 on a visual analogue scale from 0 to 10. The scores of the Quick Disabilities of the Arm, Shoulder and Hand questionnaire improved significantly. Thumb motion and grip and pinch strength did not differ significantly from the contralateral hand. There were no radiographical signs of implant subsidence or loosening. No implant required revision. Forty-five patients rated the result as excellent or good. We conclude the Moovis® is a reliable and effective implant at short- to mid-term follow-up. Level of evidence: IV

Basal Joint Osteoarthritis of the Thumb Treated with Weilby Arthroplasty: A Prospective Study on the Early Postoperative Course of 106 Consecutive Cases

2009 ◽  
Vol 34 (4) ◽  
pp. 503-505 ◽  
Author(s):  
L. S. VADSTRUP ◽  
L. SCHOU ◽  
M. E. H. BOECKSTYNS
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Grip Strength ◽  
Pinch Strength ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Postoperative Course ◽  
Basal Joint ◽  
A Prospective Study ◽  
Tendon Interposition

One hundred and six consecutive cases of osteoarthritis of the trapeziometacarpal joint, treated by tendon interposition arthroplasty as described by Weilby, were followed prospectively, with assessment of pain, mobility, pinch and grip strength at 6, 12, 26 and 52 weeks. Patient satisfaction was reviewed at 26 and 52 weeks. Preoperative visual analogue scores for pain averaged 65 and decreased postoperatively to an average of 12 at 52 weeks. The main decrease in pain occurred during the first 3 months after operation. Mobility was improved or unaltered in 82%. Average grip and pinch strength reached preoperative values (41 kPa and 20 kPa respectively) between 12 and 26 weeks after surgery and were significantly greater (58 kPa and 34 kPa) at 52 weeks. Recovery after suspension arthroplasty takes 3–6 months, which may be a disadvantage to be considered when advising patients who are considering operative treatment.

Treatment of Nonreplantable Total Thumb Amputation at the CMC Level Using Index Finger Pollicization

Hand ◽  
2021 ◽  
pp. 155894472098807
Author(s):  
Ryan M. Dickey ◽  
Anna E. Meade ◽  
Sonya P. Agnew ◽  
Andrew Y. Zhang
Keyword(s):  
Activities Of Daily Living ◽  
Grip Strength ◽  
Retrospective Review ◽  
Daily Living ◽  
Index Finger ◽  
Pinch Strength ◽  
Thenar Muscle ◽  
Thumb Amputation ◽  
Cmc Joint

Background Pollicization of the index finger is a rarely performed reconstructive option for patients with total thumb amputations with nonsalvageable carpometacarpal (CMC) joint and thenar muscles. Successful pollicization can provide basic grasp and pinch to help patients carry out activities of daily living. We present a retrospective review of 4 patients who underwent index finger pollicization for traumatic total thumb amputations. Methods A retrospective review of 4 cases of pollicization using an injured index finger for traumatic thumb amputation was performed. Patients available for follow-up were contacted for functional assessment. Outcomes including range of motion (ROM), grip strength, key pinch, 2-point discrimination, and Disabilities of the Arm, Shoulder, and Hand score were obtained. Functional thenar muscle and the CMC joint were absent in all cases. Injury mechanism was firework in 2 patients and crush in 2 patients. Results The time from injury to pollicization ranged from 8 days to 17 months. Follow-up time ranged from 10 weeks to 3 years. Three patients regularly used the pollicized thumb in activities of daily living such as writing. Tip pinch and lateral pinch along with grip strength were weak in all cases; the best recorded pinch strength was 24% and grip strength was 25% compared with the contralateral hand. The ROM of the pollicized thumb was limited. Conclusions Index finger pollicization following total thumb amputation can be a viable last-resort option for patients. The pollicized digit acts as a sensate post and avoids further morbidity from the traumatized extremity.

Two-year outcomes of Elektra prosthesis for trapeziometacarpal osteoarthritis: a longitudinal cohort study

2012 ◽  
Vol 37 (2) ◽  
pp. 130-137 ◽  
Author(s):  
P. Hernández-Cortés ◽  
M. Pajares-López ◽  
M. J. Robles-Molina ◽  
R. Gómez-Sánchez ◽  
M. A. Toledo-Romero ◽  
...  
Keyword(s):  
Cohort Study ◽  
Bone Scan ◽  
Longitudinal Cohort Study ◽  
Pinch Strength ◽  
Trapeziometacarpal Joint ◽  
Longitudinal Cohort ◽  
Radiographic Outcomes ◽  
Trapeziometacarpal Osteoarthritis ◽  
Poor Outcomes

The aim of this study was to evaluate clinical and radiographic outcomes of Elektra® trapeziometacarpal prostheses after 2 years. We present a longitudinal cohort study of 19 prostheses for the treatment of Eaton stage II and III osteoarthritis (mean follow-up of 29 months). QuickDASH score, pinch strength and mobility were determined, and radiographs were analysed. Isotope scans were taken in patients with persistent pain or suspected loosening. Although the QuickDASH score was 69 before and 38 after surgery, nine patients had pain at the trapeziometacarpal joint with radiographic osteolysis around the trapezium component and a positive bone scan uptake at subsequent follow-up. The implant was revised in three of these nine patients and another patient underwent surgery for periprosthetic fracture. Only ten of the 19 implants showed no sign of failure. Most problems derived from the trapezium cup. Because of these poor outcomes after only 2 years, we cannot recommend this implant.

A custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization: An orthosis that promotes function and improvement in patients with the first carpometacarpal joint osteoarthritis

2013 ◽  
Vol 38 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Monireh Ahmadi Bani ◽  
Mokhtar Arazpour ◽  
Stephen William Hutchins ◽  
Fereydoun Layeghi ◽  
Mahmood Bahramizadeh ◽  
...  
Keyword(s):  
Grip Strength ◽  
Clinical Relevance ◽  
Hand Function ◽  
Pinch Strength ◽  
Conservative Approach ◽  
Carpometacarpal Joint ◽  
Custom Made ◽  
First Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Improved Function

Background and aim: Patients with mild to moderate first carpometacarpal joint osteoarthritis report pain, a reduction in pinch and grip strength and hand function. The purpose of this study was to analyze the effect of a custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization on pain, function, grip strength, and key pinch in these patients. Technique: A total of 11 volunteer patients participated in this study. All the above-mentioned parameters were evaluated at baseline and also 30, 60, and 90 days after using the splint. Discussion: A decrease in pain was observed after 30 days, and this continued to improve during treatment with the splint. After 90 days of using the splint, grip strength was improved. Function and pinch strength also increased significantly and was maintained during the study period compared to baseline. Clinical relevance A custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization may be a suitable conservative approach for the treatment of first carpometacarpal joint osteoarthritis.

scholarly journals Pyrocardan Trapeziometacarpal Joint Arthroplasty—Medium-Term Outcomes

2020 ◽  
Vol 9 (06) ◽  
pp. 509-517
Author(s):  
James Logan ◽  
Susan E. Peters ◽  
Ruby Strauss ◽  
Silvia Manzanero ◽  
Gregory B. Couzens ◽  
...  
Keyword(s):  
Case Series ◽  
Postoperative Outcome ◽  
Preoperative Assessment ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Original Series ◽  
Surgery Outcome ◽  
Trapeziometacarpal Osteoarthritis ◽  
Patient Reported

Abstract Objective Pyrocardan trapeziometacarpal interposition implant is a free intra-articular spacer composed of pyrocarbon. This biconcave resurfacing implant, both ligament and bone-stock sparing, is indicated for use in early-to-moderate stage trapeziometacarpal osteoarthritis. It was hypothesized that the postoperative outcome measures of the Pyrocardan implant would be comparable to those seen with ligament reconstruction and tendon interposition (LRTI) surgeries and those reported by the designer of the implant, Phillipe Bellemère, but that strength would be greater than for LRTI. Methods In this prospective case series, 40 Pyrocardan implants were performed in 37 patients. Average age was 58 years (range: 46–71). Patients were assessed preoperatively, 3 months, 6 months, 1 year, 2 years, and beyond (long term) wherever possible. Results There have been no major complications or revision surgeries for the series. Average follow-up was 29 months (range: 12 months–7 years). Twenty-eight joints were assessed at over 2 years post index surgery. Outcome measure scores improved from preoperative assessment to the most recent follow-up equal or greater than 2 years. Average grip strength at 2 years was 30 kg, as compared with 19.6 kg in an age-matched cohort who underwent trapeziectomy and 25 kg in Bellemère's original series of Pyrocardan implants. Conclusions Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis. Patient-reported clinical outcomes were at least equivalent to LRTI and are comparable to Bellemère's original series. Grip and pinch strength appear to be better than LRTI. Level of Evidence This is a Level III, prospective observational cohort study.

Bilateral Osteoarthritis of the Trapeziometacarpal Joint Treated by Bilateral Tendon Interposition Arthroplasty

1997 ◽  
Vol 22 (1) ◽  
pp. 96-99 ◽  
Author(s):  
A. DAMEN ◽  
B. VAN DER LEI ◽  
P. H. ROBINSON
Keyword(s):  
Long Term Results ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Flexor Carpi Radialis ◽  
Trapeziometacarpal Osteoarthritis ◽  
Tendon Interposition

Twenty-four flexor carpi radialis (FCR) tendon interposition arthroplasties of the trapezium for bilateral trapeziometacarpal osteoarthritis were reviewed. Pain was reduced in all cases. Function was improved in all right hands and in 92% of the left hands. FCR tendon interposition arthroplasty for bilateral trapeziometacarpal osteoarthritis yields satisfactory long-term results on both sides.

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