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.

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.

The Effect of a Bone Tunnel During Ligament Reconstruction for Trapeziometacarpal Osteoarthritis: A 5-Year Follow-up

2015 ◽  
Vol 40 (11) ◽  
pp. 2214-2222 ◽  
Author(s):  
Kim R. Spekreijse ◽  
Guus M. Vermeulen ◽  
Muhammed A. Kedilioglu ◽  
Harm P. Slijper ◽  
Reinier Feitz ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Bone Tunnel ◽  
Trapeziometacarpal Osteoarthritis

Midterm Results after Implant-Free Patellar Fixation Technique for Medial Patellofemoral Ligament Reconstruction

2019 ◽  
Vol 33 (11) ◽  
pp. 1140-1146
Author(s):  
Philipp Mayer ◽  
Philipp Schuster ◽  
Michael Schlumberger ◽  
Martin Eichinger ◽  
Michael Pfaff ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Surgical Technique ◽  
Functional Outcome ◽  
Revision Surgery ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Return To Sports ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Preoperative Level

AbstractProblems and complications concerning the patellar fixation in medial patellofemoral ligament reconstruction (MPFLR) have been reported. The purpose of this retrospective study was to systematically analyze the surgical technique for MPFLR with a V-shaped patellar bonetunnel for implant-free fixation of an autologous gracilis tendon, allowing early functional rehabilitation, regarding restoration of the patellofemoral stability, patient satisfaction, return to sports, and technique-specific complications. In 2010, 128 cases of consecutive isolated MPFLR were performed. All these cases were included. After a minimum follow-up of 3 years, 104 cases were retrospectively analyzed (follow-up: 81.3%) with regard to redislocation, subjective functional outcome (Tegner's score and sports level compared with preoperative level), patient satisfaction, revision surgery, and technique-specific complications. After a follow-up of 45.7 ± 3.2 months, 101 of 104 cases (97.1%) showed no redislocation. Mean Tegner's score was 5.1 ± 1.8 (range, 2–9). A total of 61.5% patients reported about a higher sports level compared with their preoperative level. The patient satisfaction was high with 94.2%. In two cases (1.9%), technique-specific problems occurred as the bone bridge of the V-shaped tunnel was insufficient due to a malpositioning of the aiming device. No further technique-specific problems occurred and no revision surgery was necessary during the observational period. The presented surgical technique is safe and it reliably restores the patellofemoral stability, with a low rate of redislocations, an excellent subjective functional outcome, and a high-patient-reported satisfaction. No major technique-specific complications occurred.

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.

Trapeziectomy Alone, with Tendon Interposition or with Ligament Reconstruction?

1997 ◽  
Vol 22 (6) ◽  
pp. 689-694 ◽  
Author(s):  
T. R. C. DAVIS ◽  
O. BRADY ◽  
N. J. BARTON ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Pain Relief ◽  
Prospective Study ◽  
Ligament Reconstruction ◽  
Hand Function ◽  
Short Term ◽  
Tendon Interposition

This randomized prospective study compared the results of trapeziectomy alone, or combined with tendon interposition or ligament reconstruction in 76 women with basal thumb osteoarthritis. At 3 month and 1 year follow-up the results of the three procedures were indistinguishable in terms of pain relief, hand function and thumb strength. In the short term at least, tendon interposition and ligament reconstruction do not improve the results of trapeziectomy.

Patient-reported outcomes after Silastic replacement of the trapezium for osteoarthritis

2011 ◽  
Vol 37 (3) ◽  
pp. 263-268 ◽  
Author(s):  
N. G. Burke ◽  
J. Walsh ◽  
C. J. Moran ◽  
G. Cousins ◽  
D. Molony ◽  
...  
Keyword(s):  
Rank Correlation ◽  
Dominant Hand ◽  
Work Related ◽  
Spearman’S Rank Correlation ◽  
Trapeziometacarpal Osteoarthritis ◽  
Patient Reported ◽  
Outcome Scores ◽  
And Function ◽  
Mean Time

This retrospective study evaluated 69 Swanson trapezium replacements performed between 1990 and 2009 for trapeziometacarpal osteoarthritis in 58 patients. Pain and function were assessed using the Michigan Hand Questionnaire and the Disability of the Arm, Shoulder and Hand questionnaire. Patients had a mean age of 62 years at the time of surgery, with a mean time of 7.7 years (range 9 months to 19 years) from surgery to follow-up interview. There was no association between outcome scores and the length of follow-up, suggesting that the results are maintained over time (Spearman’s rank correlation test < ±0.2). Scores for activities of daily living and work-related activities were higher when surgery was on the dominant hand ( p < 0.05). Silicone trapezium replacement remains a good option for patients with painful trapeziometacarpal osteoarthritis that has not responded to nonoperative management.

scholarly journals Assessment of pain control, quality of life, and predictors of success after gamma knife surgery for the treatment of trigeminal neuralgia

2005 ◽  
Vol 18 (5) ◽  
pp. 1-7 ◽  
Author(s):  
Ajay Jawahar ◽  
Rishi Wadhwa ◽  
Caglar Berk ◽  
Gloria Caldito ◽  
Allyson Delaune ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Pain Control ◽  
Gamma Knife Surgery ◽  
Patient Satisfaction Score

Object There are various surgical treatment alternatives for trigeminal neuralgia (TN), but there is no single scale that can be used uniformly to assess and compare one type of intervention with the others. In this study the objectives were to determine factors associated with pain control, pain-free survival, residual pain, and recurrence after gamma knife surgery (GKS) treatment for TN, and to correlate the patients' self-reported quality of life (QOL) and satisfaction with the aforementioned factors. Methods Between the years 2000 and 2004, the authors treated 81 patients with medically refractory TN by using GKS. Fifty-two patients responded to a questionnaire regarding pain control, activities of daily living, QOL, and patient satisfaction. The median follow-up duration was 16.5 months. Twenty-two patients (42.3%) had complete pain relief, 14 (26.9%) had partial but satisfactory pain relief, and in 16 patients (30.8%) the treatment failed. Seven patients (13.5%) reported a recurrence during the follow-up period, and 25 (48.1%) reported a significant (> 50%) decrease in their pain within the 1st month posttreatment. The mean decrease in the total dose of pain medication was 75%. Patients' self-reported QOL scores improved 90% and the overall patient satisfaction score was 80%. Conclusions The authors found that GKS is a minimally invasive and effective procedure that yields a favorable outcome for patients with recurrent or refractory TN. It may also be offered as a first-line surgical modality for any patients with TN who are unsuited or unwilling to undergo microvascular decompression.

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.

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