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

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

<p><strong>Background:</strong> 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.<strong><em> </em></strong></p><p><strong>Methods:</strong> 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.</p><p><strong>Results:</strong> 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 1<sup>st</sup> 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.<strong> </strong></p><p><strong>Conclusions</strong>: 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.<strong></strong></p>

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 ◽  
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.

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

2004 ◽  
Vol 29 (1) ◽  
pp. 40-41 ◽  
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.

Comparison of Ligament Reconstruction Tendon Interposition and Trapeziometacarpal Interposition Arthroplasty for Basal Joint Arthritis

Orthopedics ◽  
2008 ◽  
Vol 31 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Louis Catalano ◽  
Landon T. Horne ◽  
Evan Fischer ◽  
O. Alton Barron ◽  
Steven Z. Glickel
Keyword(s):  
Ligament Reconstruction ◽  
Interposition Arthroplasty ◽  
Basal Joint ◽  
Tendon Interposition ◽  
Joint Arthritis

TREATMENT OF BASAL JOINT ARTHRITIS OF THE THUMB: TRAPEZIECTOMY WITH OR WITHOUT TENDON INTERPOSITION/LIGAMENT RECONSTRUCTION

Hand Surgery ◽  
2004 ◽  
Vol 09 (01) ◽  
pp. 5-9 ◽  
Author(s):  
L. De Smet ◽  
W. Sioen ◽  
D. Spaepen ◽  
H. van Ransbeeck
Keyword(s):  
Ligament Reconstruction ◽  
Surgical Techniques ◽  
Dash Score ◽  
Pinch Force ◽  
Proximal Migration ◽  
Group I ◽  
Basal Joint ◽  
Group Ii ◽  
Gripping Force ◽  
Joint Arthritis

This prospective study compared the outcome — subjective, objective and radiographic — of two surgical techniques for treating basal joint arthritis of the thumb: a "simple" trapeziectomy (group I) and a ligament reconstruction/tendon (group II) interposition technique. There were respectively 22 patients in group I and 34 in group II, all women with primary osteoarthritis. Both techniques gave favourable results and there were no significant differences for pain relief, patient satisfaction, mobility, DASH-score, key pinch force and gripping force. However in group II, the trapezial height was better preserved indicating that the proximal migration of the thumb was prevented or limited. There was also a significant correlation between the remaining trapezial space and key pinch force.

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.

scholarly journals Outcome of trapeziectomy with ligament reconstruction tendon interposition for the treatment of advanced thumb carpometacarpal arthritis: a prospective study

2021 ◽  
Vol 7 (2) ◽  
pp. 252
Author(s):  
Eknoor Kaur ◽  
Narender Saini ◽  
Shashank Sharma ◽  
Devi Sahai Meena
Keyword(s):  
Ligament Reconstruction ◽  
Dash Score ◽  
Before And After ◽  
The Mean ◽  
Thumb Carpometacarpal ◽  
A Prospective Study ◽  
Tendon Interposition ◽  
Grip Power ◽  
Joint Arthritis ◽  
Score Range

<p><strong>Background</strong>: The purpose of this study is to assess the functional outcome of the cases with advanced thumb carpometacarpal (CMC) arthritis treated with trapeziectomy and ligament reconstruction tendon interposition (LRTI) in terms of visual analogue scale (VAS), disabilities of the arm, shoulder and hand (DASH) score, Kapandji score, range of motion (ROM) of radial and volar abduction of the thumb, grip power, key pinch and the height of the trapezial space.</p><p><strong>Methods</strong>: In a prospective before and after interventional study of 30 patients with the advanced thumb CMC joint arthritis underwent the procedure. An average follows up period was 17.9 months.</p><p><strong>Results:</strong> The mean VAS decreased from 8.17 to 2.70. The mean Kapandji score and DASH score improved from 3.47 and 71.62 preoperative to 8.23 and 14.46 postoperative.  Mean ROM for radial and volar abduction increased from 42.57° and 48° to 61°and 64.73° respectively. Mean key pinch power and grip power increased from 2.80 kg and 3.47 kg to 4.70 kg and 9.01 kg respectively.  There was a significant decrease in height of the trapezial space. Three patient complaint of the persistent pain at the surgical site and not much improvement in the DASH score.</p><p><strong>Conclusions:</strong>  Trapeziectomy with LRTI using flexor carpi radialis (FCR) transfer is an effective treatment for the advanced thumb CMC arthritis. This procedure stabilizes thumb metacarpal and provide enough support which prevents the collapse of metacarpal into dead space.</p>

Basal joint arthritis: Trapeziectomy with ligament reconstruction and tendon interposition arthroplasty

1996 ◽  
Vol 21 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Robert E. Lins ◽  
Richard H. Gelberman ◽  
Lisa McKeown ◽  
Jeffrey N. Katz ◽  
R. Kumar Kadiyala
Keyword(s):  
Ligament Reconstruction ◽  
Interposition Arthroplasty ◽  
Basal Joint ◽  
Tendon Interposition ◽  
Joint Arthritis

EARLY FUNCTIONAL IMPROVEMENT AFTER A MODIFIED LIGAMENT RECONSTRUCTION TENDON INTERPOSITION ARTHROPLASTY FOR THUMB BASAL JOINT ARTHRITIS

Hand Surgery ◽  
2008 ◽  
Vol 13 (03) ◽  
pp. 153-158 ◽  
Author(s):  
Toshiki Miura ◽  
Koji Osuka ◽  
Shozo Itoh ◽  
Takumi Nakagawa ◽  
Hirotaka Kawano ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Functional Change ◽  
Functional Improvement ◽  
Functional Changes ◽  
Post Operative Period ◽  
Basal Joint ◽  
Before And After ◽  
Tendon Interposition ◽  
Joint Arthritis

Many modifications to trapeziectomy have been proposed for the treatment of thumb basal joint arthritis. Their final outcomes have been discussed intensively, whereas functional changes in the early post-operative period have not been fully documented. The purpose of the present study is to evaluate an early functional change following our modified ligament reconstruction with tendon interposition (LRTI) arthroplasty. Nine patients (ten thumbs) were included in this study. Pain levels, strength, and mobility were assessed before and after surgery at intervals of two months. Pain level significantly improved at two months after surgery. Grip and pinch strengths had increased gradually after a temporal decrease at two-month follow-up, and were significantly stronger at six months after surgery. Palmar abduction improved significantly at six months after surgery, whereas opposition did not change significantly. A modified LRTI is an effective procedure in terms of early functional improvement of pain, strength, and mobility.

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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