Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis

2012 ◽  
Vol 38 (8) ◽  
pp. 844-850 ◽  
Author(s):  
M. Rubino ◽  
A. Civani ◽  
D. Pagani ◽  
V. Sansone
Keyword(s):  
Clinical Outcome ◽  
Surgical Techniques ◽  
Pinch Strength ◽  
Dash Score ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Excision Arthroplasty ◽  
Joint Arthritis

We describe a technique that arose from the observation of the clinical outcome of failed arthrodeses of the thumb carpometacarpal joint. In these cases a pseudoarthrosis developed which, surprisingly, rarely lead to a poor clinical outcome. Thus we developed a simple technique which deliberately caused the formation of a narrow pseudoarthrosis in the carpometacarpal joint. We present a retrospective review of 248 consecutive patients treated for Eaton stages II and III osteoarthritis. We observed a statistically significant improvement in mean appositional and oppositional pinch strength, mean DASH score (63.8 pre-operatively to 10.5 at final follow-up), and the mean pain score (8.3 to 0.2). We conclude that trapeziometacarpal limited excision arthroplasty is a simple and reliable alternative to existing surgical techniques for treating Stage II or III thumb carpometacarpal joint arthritis.

ARTHROSCOPIC EVALUATION AND TREATMENT BY TENDON INTERPOSITIONAL ARTHROPLASTY OF FIRST CARPOMETACARPAL JOINT ARTHRITIS

Hand Surgery ◽  
2007 ◽  
Vol 12 (01) ◽  
pp. 35-39 ◽  
Author(s):  
L. Pegoli ◽  
C. Parolo ◽  
T. Ogawa ◽  
S. Toh ◽  
G. Pajardi
Keyword(s):  
Pinch Strength ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Mayo Score ◽  
Basal Joint ◽  
Palmaris Longus Tendon ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Joint Arthritis

Basal joint arthritis of the thumb is usually seen in females beginning from the fourth and fifth decades. In the last two decades, arthroscopic techniques have brought new chances of diagnosis and treatment for this condition. In this paper, the authors describe the indications and their experience concerning arthroscopic hemitrapezectomy and tendon interposition using the palmaris longus tendon. A series of 16 patients with a maximum follow-up of 12 months is analysed. All of the 16 patients were followed and assessed with grasp strength, pinch strength, DASH and MAYO evaluation score both pre- and post-operatively at 12 months follow-up. According to the MAYO score, there were six excellent results, six good, three fair and one poor. No complications occurred. According to our preliminary results, this procedure with the proper indications gives a valid option for the treatment of thumb carpometacarpal joint arthritis in stages I and II according to Eaton's classification.

Description and Clinical Assessment of the Bone Block Tendon Interposition Technique for the Management of Thumb Carpometacarpal Joint Osteoarthritis

2018 ◽  
Vol 23 (04) ◽  
pp. 515-519
Author(s):  
Diego F. Rincon Cardozo ◽  
Wynston J. Alvarez Martinez ◽  
Jhon F. Castañeda Lopez ◽  
Fredy A. Angarita Maldonado ◽  
Juliana A. Rojas Neira ◽  
...  
Keyword(s):  
Case Series ◽  
Functional Results ◽  
Interference Screw ◽  
Pinch Strength ◽  
Bone Block ◽  
Dash Score ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
And Function

Background: Pellegrini’s surgical technique is the most useful for thumb carpometacarpal joint osteoarthritis. The purpose of this paper is to describe the technique of a modified version using a bone block in the tunnel through which the flexor carpi radialis tendon is passed (BBTI). Methods: Case series of patients diagnosed with osteoarthritis of the thumb carpometacarpal joint, in stage II or higher based on Eaton’s classification, that were intervened using the BBTI technique for a 2-year period. Grip and pinch strength, range of motion, and 1–2 metacarpal angle were evaluated. Pain and function were measured using the visual analogue scale and the Disabilities of the Arm, Shoulder and Hand (DASH) scale. Results: The study included 16 cases in 14 patients (11 women and 3 men), with an average age of 55.7 ± 7.1 years. Encouraging results were obtained, with an average DASH score of 24.3 ± 17.9 and a minimum VAS pain score. A total of 58% showed a grip strength of over 80% and the postoperative movement was equivalent to the contralateral limb. No cases of infection were reported, and only two minor complications were observed. Conclusions: The BBTI technique is a surgical option that incorporates an interference screw, offering good functional results for managing osteoarthritis of the thumb carpometacarpal joint, with a similar complication rate to that of the original technique.

scholarly journals Percutaneous Trapeziometacarpal Arthrodesis in Thumb Carpometacarpal Joint Arthritis: A New Surgical Approach

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
D. Mifsut-Miedes ◽  
J. R. Rodríguez-Collell ◽  
A. Valverde-Navarro ◽  
E. M. González-Soler
Keyword(s):  
Minimally Invasive ◽  
Scientific Evidence ◽  
Surgical Techniques ◽  
Invasive Technique ◽  
Carpometacarpal Joint ◽  
Invasive Approach ◽  
Thumb Carpometacarpal Joint ◽  
High Prevalence ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis

The high prevalence of trapeziometacarpal arthritis has resulted in the development of several surgical techniques intended to treat patients failing conservative treatment. However, there is no scientific evidence of the superiority of one technique over others. Open arthrodesis has up to now been successfully used to treat this condition. We believe that performing the technique using a minimally invasive approach with long and short Shannon burrs together with the tapered burr included in the MIS foot instrument set can yield satisfactory results. This article provides a description of this minimally invasive technique performed on a seventy-year-old woman with rhizarthrosis and an anatomical description of the approach in a human cadaver.

The “Pillow” Technique for Thumb Carpometacarpal Joint Arthritis: Cohort Study With 10- to 15-Year Follow-Up

2016 ◽  
Vol 41 (7) ◽  
pp. 775-781
Author(s):  
Panagiotis Givissis ◽  
Nikolaos Platon Sachinis ◽  
Panagiotis Akritopoulos ◽  
Stavros I. Stavridis ◽  
Anastasios Christodoulou
Keyword(s):  
Cohort Study ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis

A Modified Suture Suspension Arthroplasty Technique for the Treatment of Basal Joint Arthritis: Short- to Intermediate-Term Outcomes

Hand ◽  
2020 ◽  
pp. 155894471988666 ◽  
Author(s):  
Ather Mirza ◽  
Justin B. Mirza ◽  
Laura Klingbeil ◽  
Joseph F. Pavlik ◽  
Jonathan Muratori ◽  
...  
Keyword(s):  
Contralateral Side ◽  
Pinch Strength ◽  
Dash Score ◽  
Radiographic Images ◽  
Basal Joint ◽  
Thumb Carpometacarpal ◽  
Relationship Of ◽  
Joint Arthritis ◽  
Suture Suspension

Background: To present a retrospective study on the outcomes of a modified version of suture suspension arthroplasty with trapeziectomy on patients with thumb basal joint arthritis and to evaluate the relationship between the degree of subsidence and functional outcome. Methods: We performed a chart review on 67 patients (75 thumbs) who were surgically treated for thumb carpometacarpal osteoarthritis with trapeziectomy and suture suspension arthroplasty from May 2010 to May 2016. Outcome measures included Disabilities of the Arm, Shoulder and Hand (DASH), grip strength, lateral/precision pinch strength, range of motion, and return to work/resumption of usual activities. Radiographic images were used to measure first metacarpal subsidence into the trapezial space. Results: Clinical outcomes were satisfactory, showing an initial postoperative DASH score of 45.94, which decreased to 27.93 at 6 months postoperatively and to 19.69 at 1 year postoperatively. Radiographic images revealed a mean first metacarpal subsidence of 39% compared with the preoperative images. Grip and pinch strengths showed steady improvement from initial postoperative to final follow-up visits, resulting in 90% recovery of gross grasp, 77% recovery of lateral pinch, and 79% recovery of precision pinch compared with the contralateral side. Conclusions: Our study has found that suture suspension arthroplasty with trapeziectomy is an effective treatment for thumb basal joint arthritis. Suture suspension arthroplasty allows for short immobilization time, avoids tendon sacrifice, avoids anchor use, and leaves a cosmetically appealing scar. Furthermore, a relationship of any significance between postoperative first metacarpal subsidence and functional outcomes does not appear.

A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis

2016 ◽  
Vol 41 (7) ◽  
pp. 710-718 ◽  
Author(s):  
M. Rubino ◽  
L. Cavagnaro ◽  
V. Sansone
Keyword(s):  
Simple Technique ◽  
Stage Iv ◽  
Pinch Strength ◽  
Dash Score ◽  
Level Of Evidence ◽  
First Ray ◽  
Excision Arthroplasty ◽  
Surgical Treatments ◽  
New Surgical Technique

We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2–6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis. Level of evidence: 4

scholarly journals Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis

2018 ◽  
Vol 23 (4) ◽  
pp. 223
Author(s):  
Sehun Kim ◽  
Hyun Sik Gong ◽  
Se Yeon Lee ◽  
Minho Lee ◽  
Jihyeung Kim ◽  
...  
Keyword(s):  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis ◽  
Suture Suspension

Early Results of the ARPE Arthroplasty Versus Trapeziectomy for the Treatment of Thumb Carpometacarpal Joint Osteoarthritis

2017 ◽  
Vol 22 (04) ◽  
pp. 472-478 ◽  
Author(s):  
Johnathan D. Craik ◽  
Simon Glasgow ◽  
James Andren ◽  
Mark Sims ◽  
Reza Mansouri ◽  
...  
Keyword(s):  
Treatment Options ◽  
Complication Rates ◽  
Implant Survival ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Early Results ◽  
Functional Scores ◽  
Thumb Carpometacarpal ◽  
Quick Dash

Background: Thumb carpometacarpal joint arthroplasty for osteoarthritis may hold advantages over trapeziectomy by preserving range of motion, whilst providing stability and preventing thumb shortening. Methods: We compare functional and satisfaction outcomes scores, radiological shortening and complication rates between patients treated with trapeziectomy and those receiving the ARPE thumb CMCJ arthroplasty. Results: Seventy-five trapeziectomies and one hundred and ten ARPE arthroplasties were performed over the study period. Both treatments resulted in significant improvements in functional scores. When matching patients according to pre-operative function, patients receiving the ARPE arthroplasty had better post-operative function (Quick DASH: trapeziectomy = 25.1, ARPE = 16.8). More patients receiving the ARPE arthroplasty were satisfied with their treatment (trapeziectomy = 7.8/10, ARPE = 8.7/10) and would have the same treatment again (trapeziectomy = 76%, ARPE = 89%). The ARPE also resulted in less thumb shortening. However the ARPE arthroplasty is associated with a higher complication rate, with 14% of patients requiring further surgery at a mean of 2 years follow up (95% implant survival). Conclusions: Both trapeziectomy and the ARPE CMCJ arthroplasty are effective treatment options for thumb CMCJ osteoarthritis. Arthroplasty may offer potential advantages in terms of post-operative function and patient satisfaction. However the risk of complications and requirement for further surgery is greater and must be carefully considered during patient selection and pre-operative counselling.

Sign in / Sign up

Export Citation Format

Share Document