Trapeziectomy with Ligament Reconstruction and Tendon Interposition versus Trapeziometacarpal Joint Replacement for Thumb Carpometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Mobeen Khalid Qureshi ◽  
Usman Ali Halim ◽  
Ahmad Sulaiman Khaled ◽  
Simon John Roche ◽  
Mohammed Shoaib Arshad
Keyword(s):  
Systematic Review ◽  
Joint Replacement ◽  
Ligament Reconstruction ◽  
Meta Analysis ◽  
Treatment Modalities ◽  
Trapeziometacarpal Joint ◽  
Significant Difference ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Carpometacarpal Osteoarthritis

Abstract Background The trapeziometacarpal articulation in the thumb is a joint that is second-most commonly affected by osteoarthritis, and this can lead to considerable hand pain and disability. Currently, there is a multiplicity of surgical options available to address this problem, yet none has proven to be significantly superior to the others. Objective This study aims to compare the outcome of trapeziectomy with ligament reconstruction and tendon interposition versus trapeziometacarpal joint replacement for thumb carpometacarpal osteoarthritis. Materials and Methods A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. The NICE Healthcare Databases Advanced Search (HDAS) tool was used to search articles. One randomized controlled trial (RCT), one prospective cohort study and two retrospective cohort studies were identified. Results Our results demonstrate a significant difference in the Quick Disabilities of the Arm Shoulder and Hand (QDASH) score between the trapeziectomy with ligament reconstruction and tendon interposition (LRTI) and Joint Replacement groups with the joint replacement group exhibiting better QDASH scores than the LRTI group. We also found that those who had a joint replacement had a significantly better thumb opposition than those in the LRTI group, as demonstrated by a superior Kapandji score. However, the complication rate of joint replacement appears to be higher. Conclusion Our study reveals that while both treatment options are valid, the limited body of evidence currently available shows that joint replacement carries more risks and thus should not replace the current standard treatment of trapeziectomy with LRTI. This study highlights the need for more trials to be performed to more accurately compare the two treatment modalities. For the time being, we advocate that joint replacement is only performed by surgeons who perform this procedure regularly to reduce the risk of complications.

scholarly journals Five Percent Potassium Hydroxide for the Treatment of Anogenital Warts: A Systematic Review and Meta-analysis

2019 ◽  
Vol 53 (2) ◽  
Author(s):  
Shahara Abalos-Babaran ◽  
Jay-V James G. Barit ◽  
Francisca DC. Roa
Keyword(s):  
Systematic Review ◽  
Co2 Laser ◽  
Clearance Rate ◽  
Potassium Hydroxide ◽  
Meta Analysis ◽  
Treatment Modalities ◽  
Comparable Efficacy ◽  
Laser Vaporization ◽  
Anogenital Warts ◽  
Significant Difference

Background and Objectives. Potassium hydroxide (KOH) is effective and safe as treatment of viral dermatoses. No systematic review has been done reporting its efficacy as a treatment for anogenital warts. Methods. A systematic literature search for controlled clinical trials using KOH, any drug or ablative procedure measuring the clearance rate was conducted. Analysis was done using RevMan v5.3 software. Results. Four low quality trials, composed of 197 patients were included but only two qualified for meta-analysis. Two studies compared KOH to cryotherapy while the two other trials compared KOH to intralesional 5-fluorouracil (FU) + salicylic acid (SA) and carbon dioxide (CO2) laser vaporization. The KOH group showed a higher clearance rate compared to cryotherapy (RR= 1.40, P> 0.05, I2=39 %) and no recurrence was noted (RR= 0.17, P> 0.05, I2=0) but the difference is not statistically significant. Isik et al., 2014 and Asadi et al., demonstrated that there was no significant difference among groups receiving KOH, 5-FU+SA and CO2 laser vaporization in the mean lesion count and size at follow up visits. (P > 0.05). Conclusions. Potassium hydroxide has comparable efficacy to the present treatment modalities but well-structured RCTs are needed to further support its use.

Ligament Reconstruction with or without Tendon Interposition to Treat Primary Thumb Carpometacarpal Osteoarthritis

2005 ◽  
Vol 87 ◽  
pp. 78-85 ◽  
Author(s):  
GABRIELE KRIEGS-AU ◽  
GERT PETJE ◽  
EVA FOJTL ◽  
RUDOLF GANGER ◽  
INGRID ZACHS
Keyword(s):  
Ligament Reconstruction ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Carpometacarpal Osteoarthritis

scholarly journals Is Remnant Preservation in Anterior Cruciate Ligament Reconstruction Superior to the Standard Technique? A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Han Wang ◽  
Ziming Liu ◽  
Yuwan Li ◽  
Yihang Peng ◽  
Wei Xu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Cruciate Ligament Reconstruction ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Postoperative Knee

Purpose. This is a systematic review and meta-analysis of current evidence that aims at comparing the clinical outcomes of remnant-preserving anterior cruciate ligament reconstruction (ACLR) and standard ACLR. Methods. A systematic review of randomized controlled studies and cohort studies comparing remnant-preserving ACLR with standard ACLR with a minimum level of evidence of II was performed. Studies were included by strict inclusion and exclusion criteria. Extracted data were summarized as preoperative conditions, postoperative clinical outcomes, and postoperative complications. When feasible, meta-analysis was performed with RevMan5.3 software. Study methodological quality was evaluated with the modified Coleman methodology score (CMS). Results. Eleven studies (n = 466 remnant-preserving and n = 536 standard) met the inclusion criteria. The mean modified CMS for all included studies was 85.8 (range: 77–92 on a 100-point scale). In total, 466 patients underwent remnant-preserving ACLR by 3 different procedures: standard ACLR plus tibial remnant tensioning (n = 283), selective-bundle augmentation (n = 49), and standard ACLR plus tibial remnant sparing (n = 134). Remnant-preserving ACLR provided a superior outcome of postoperative knee anterior stability (WMD = −0.42, 95% CI, −0.66, −0.17; P<0.01) and Lysholm score (WMD = 2.01, 95% CI, 0.53 to 3.50; P<0.01). There was no significant difference between the two groups with respect to second-look arthroscopy (OR = 1.38, 95% CI, 0.53, 3.62; P=0.51), complications (OR = 1.24 95% CI, 0.76, 2.02; P=0.39), International Knee Documentation Committee (IKDC) subject scores, IKDC grades, Lachman test, and pivot-shift test. Summary/conclusion. Remnant-preserving ACLR promotes similar graft synovial coverage and revascularization to standard ACLR. Equivalent or superior postoperative knee stability and clinical scores were observed for remnant-preserving ACLR compared with standard ACLR. No significant difference in the total complication rate between the groups was evident.

Trapeziectomy and ligament reconstruction tendon interposition after failed trapeziometacarpal joint replacement

2016 ◽  
Vol 35 (1) ◽  
pp. 21-26 ◽  
Author(s):  
H. Lenoir ◽  
A. Erbland ◽  
D. Lumens ◽  
B. Coulet ◽  
M. Chammas
Keyword(s):  
Joint Replacement ◽  
Ligament Reconstruction ◽  
Trapeziometacarpal Joint ◽  
Tendon Interposition

Effectiveness of manual therapy in patients with thumb carpometacarpal osteoarthritis: a systematic review and meta-analysis

2021 ◽  
pp. 1-10
Author(s):  
Héctor Gutiérrez Espinoza ◽  
Felipe Araya-Quintanilla ◽  
Cristian Olguín-Huerta ◽  
Juan Valenzuela-Fuenzalida ◽  
Rene Jorquera-Aguilera ◽  
...  
Keyword(s):  
Systematic Review ◽  
Manual Therapy ◽  
Meta Analysis ◽  
Thumb Carpometacarpal ◽  
Carpometacarpal Osteoarthritis

scholarly journals Effectiveness of splinting for pain and function in people with thumb carpometacarpal osteoarthritis: a systematic review with meta-analysis

2019 ◽  
Vol 27 (4) ◽  
pp. 547-559 ◽  
Author(s):  
M. Buhler ◽  
C.M. Chapple ◽  
S. Stebbings ◽  
B. Sangelaji ◽  
G.D. Baxter
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Thumb Carpometacarpal ◽  
And Function ◽  
Carpometacarpal Osteoarthritis

scholarly journals Comparison of arthrodesis and arthroplasty of Chinese thumb carpometacarpal osteoarthritis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jianfeng Li ◽  
Dacun Li ◽  
Guanglei Tian ◽  
Wentong Zhang
Keyword(s):  
Grip Strength ◽  
Ligament Reconstruction ◽  
Subjective Evaluation ◽  
Chinese Patients ◽  
Pinch Strength ◽  
Dash Score ◽  
Advantages And Disadvantages ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Carpometacarpal Osteoarthritis

Abstract Background The thumb carpometacarpal (CMC) osteoarthritis is very common. Multiple methods are used to treat progressive thumb CMC osteoarthritis, among which trapeziometacarpal arthrodesis and trapezial excision with ligament reconstruction and tendon interposition (LRTI) are the most common. These two surgical treatment methods have received mixed reviews in previous studies in the west patients. This retrospective study studied the effects, advantages, and disadvantages of arthrodesis and arthroplasty for treating thumb carpometacarpal osteoarthritis in Chinese patients. Methods Between February 2012 and September 2017, 39 Chinese patients with stage II or III thumb carpometacarpal osteoarthritis underwent surgery (trapeziometacarpal arthrodesis in 22, trapezial excision with ligament reconstruction and tendon interposition in 17). Postoperative objective and subjective evaluations were performed. The objective evaluation involved grip strength, pinch strength, thumb abduction degree (palmar and radial), and Kapandji opposition scores. The subjective evaluation involved visual analog scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Results Intergroup differences in pinch strength, thumb abduction degrees (palmar and radial), and Kapandji opposition scores were obvious, whereas those in grip strength, VAS score, and DASH score were not. Conclusion In Chinese patients, both techniques relieved pain and improve grip strength. Arthrodesis displayed better pinch strength, while arthroplasty displayed better motor function. Patients were satisfied with the effects of both techniques.

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