Surgical Treatment for Thumb CMC Joint Arthritis

2013 ◽  
Vol 9 (2) ◽  
pp. 113-118
Author(s):  
Brian Gander ◽  
Ronit Wollstein
Keyword(s):  
Surgical Treatment ◽  
Joint Arthritis ◽  
Cmc Joint

Capitolunate Instability and Clinical Outcomes after Resection of the STT Joint in CMC Joint Arthritis

2015 ◽  
Vol 04 (S 02) ◽  
Author(s):  
Mark Ross ◽  
David Gilpin ◽  
Susan Peters ◽  
Bradley Gilpin ◽  
Gregory Couzens
Keyword(s):  
Clinical Outcomes ◽  
Joint Arthritis ◽  
Cmc Joint

scholarly journals Evidence-Based Practice in the Surgical Treatment of Thumb Carpometacarpal Joint Arthritis

2017 ◽  
Vol 42 (2) ◽  
pp. 104-112.e1 ◽  
Author(s):  
Frank Yuan ◽  
Oluseyi Aliu ◽  
Kevin C. Chung ◽  
Elham Mahmoudi
Keyword(s):  
Surgical Treatment ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis

Optimal Position of the Suture Button Suspensionplasty (TightRope) for Thumb Basal Joint Arthritis

Hand ◽  
2020 ◽  
pp. 155894472090655 ◽  
Author(s):  
Bryan A. Hozack ◽  
Brianna Fram ◽  
Asif M. Ilyas ◽  
Michael Rivlin ◽  
Frederic E. Liss ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
High Angle ◽  
Optimal Position ◽  
Suture Button ◽  
Axial Stability ◽  
Basal Joint ◽  
Before And After ◽  
Fresh Frozen ◽  
Joint Arthritis ◽  
Anterior Posterior

Background: Surgical treatment of basal joint arthritis commonly consists of trapeziectomy followed by various suspensionplasty techniques to provide stability to the thumb ray. Our study goal was to assess the motion and stability of the thumb ray after trapeziectomy and placement of a suture button (Mini TightRope®, Arthrex, Naples, Florida) in a high- or low-angle trajectory. We hypothesized that a low-angle trajectory would yield the greatest stability while providing maximal motion of the thumb. Methods: Eleven fresh-frozen cadaver arms were imaged fluoroscopically in anterior-posterior and lateral views before and after trapeziectomy, and after placement of low- and high-angle suture buttons. The intermetacarpal angle between the thumb and index metacarpals was measured after application of a standard force. Radial abduction, opposition, subsidence, palmar abduction, adduction, and subsidence were measured. Results: Compared to posttrapeziectomy constructs, low- and high-angle TightRope constructs demonstrated less subsidence, low-angle TightRopes had less palmar abduction, and high-angle TightRope constructs had less radial abduction and adduction. High-angle TightRopes allowed more palmar abduction than low-angle constructs. The high-angle TightRopes trended toward more subsidence than low-angle constructs, although it was not significant. Conclusions: Both TightRope constructs provided improved axial stability after trapeziectomy while not excessively limiting any one motion of the thumb. Compared to the high-angle trajectory, the low-angle TightRope placement provided a more stable construct with respect to subsidence and angular motion. Given the concern for excessive motion of the first metacarpal base with the high-angle construct, we recommend a low-angle trajectory TightRope placement.

Effect of Extension Osteotomy of the 1st Metacarpal on Laxity of the Thumb Carpometacarpal Joint

2002 ◽  
Author(s):  
Matthew F. Koff ◽  
Niket Shrivastava ◽  
Amy E. Abbot ◽  
Benton E. Heyworth ◽  
Thomas R. Gardner ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hand Function ◽  
Joint Stiffness ◽  
Joint Laxity ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Common Solution ◽  
Clinical Literature ◽  
Thumb Carpometacarpal ◽  
Cmc Joint

Osteoarthritis (OA) of the human thumb carpometacarpal (CMC) joint is a debilitating disease. It has been proposed in the clinical literature that joint ligamentous laxity, or joint looseness, is a major etiological factor in OA of the CMC joint (Figure1) [1–4]. Previous investigations of laxity and stability of the human thumb CMC joint have been performed visually, with no quantitative measures of joint laxity recorded [5–7]. Surgical treatment has been a common solution to reduce the pain associated with CMC OA. One treatment, extension osteotomy of the 1st metacarpal, has been suggested not only to reduce the pain of OA, but also improve hand function [8], however, little is known about its biomechanical effects. A complete description of joint laxity requires that all physiological directions of motion be fully tested. A custom-designed, 4 degree of freedom tester was constructed and instrumented for displacement and load in the distraction-compression, dorsal-volar, pronation-supination, and radial-ulnar directions. The purpose of this study was to use this device to: 1) Measure the joint laxity and compliance of non-OA human thumb CMC joints and 2) Determine the effect that a simulated extension osteotomy has on joint laxity and joint stiffness. This study provides an accurate baseline for future comparisons with osteoarthritic, surgically corrected, and otherwise non-healthy CMC joints.

scholarly journals Complications with the Use of Artelon in Thumb CMC Joint Arthritis

Hand ◽  
2011 ◽  
Vol 6 (3) ◽  
pp. 282-286 ◽  
Author(s):  
Sylvan Clarke ◽  
William Hagberg ◽  
Robert A. Kaufmann ◽  
Aaron Grand ◽  
Ronit Wollstein
Keyword(s):  
Joint Arthritis ◽  
Cmc Joint

Cell-Enriched Lipoaspirate Arthroplasty: A Novel Approach to First Carpometacarpal Joint Arthritis

Hand Surgery ◽  
2015 ◽  
Vol 20 (03) ◽  
pp. 479-481 ◽  
Author(s):  
Stefan Bohr ◽  
Hans Oliver Rennekampff ◽  
Norbert Pallua
Keyword(s):  
Treated Patient ◽  
Minimal Invasive ◽  
Invasive Technique ◽  
Carpometacarpal Joint ◽  
Novel Approach ◽  
Basal Joint ◽  
The Cost ◽  
Joint Arthritis ◽  
Cmc Joint

We report a novel, minimal invasive technique for the treatment of symptomatic arthritis of the carpometacarpal (CMC) joint of the thumb, here termed Cell-Enriched Liposaspirate Arthroplasty (CELA). For CELA, autologous fat tissue was harvested using standard liposuction technique followed by an extra-corporal cellular enrichment step. Finally, 1 ml of cell-enriched lipoaspirate was injected into the CMC-joint. Following CELA, the treated patient became pain free within five weeks with a follow-up of 12 months. We conclude that CELA performed on selected cases of arthritis of finger joints such as the basal joint of the thumb has the potential to greatly reduce or delay the necessity for more invasive procedures which tend to improve symptoms of pain at the cost of grip strength and range-of-motion.

scholarly journals Medicare Spending and Evidence-Based Approach in Surgical Treatment of Thumb Carpometacarpal Joint Arthritis

2016 ◽  
Vol 137 (6) ◽  
pp. 980e-989e ◽  
Author(s):  
Elham Mahmoudi ◽  
Frank Yuan ◽  
Meghan E. Lark ◽  
Oluseyi Aliu ◽  
Kevin C. Chung
Keyword(s):  
Surgical Treatment ◽  
Evidence Based ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis ◽  
Medicare Spending

scholarly journals The Effect of Metacarpophalangeal Joint Hyperextension on Outcomes in the Surgical Treatment of Carpometacarpal Joint Arthritis

2016 ◽  
Vol 06 (03) ◽  
pp. 188-193 ◽  
Author(s):  
David Brogan ◽  
Rose van Hogezand ◽  
Nikola Babovic ◽  
Brian Carlsen ◽  
Sanjeev Kakar
Keyword(s):  
Surgical Treatment ◽  
Grip Strength ◽  
Functional Outcomes ◽  
Metacarpophalangeal Joint ◽  
Bone Tunnel ◽  
Level Of Evidence ◽  
Unequal Variances ◽  
Pinch Grip ◽  
Retrospective Comparative Study ◽  
Joint Arthritis

Purpose In the surgical treatment of thumb carpometacarpal (CMC) joint arthritis, the effect of mild preoperative metacarpophalangeal (MCP) hyperextension on postoperative functional outcomes is unknown. We sought to examine outcomes after surgical treatment of CMC arthritis in patients with and without mild preexisting MCP deformity. Methods A retrospective review was conducted to analyze the functional outcomes of patients treated for CMC arthritis at a single institution from March 1998 to May 2009. All patients were treated with one of two standard CMC arthroplasty procedures—either ligament reconstruction tendon interposition (LRTI) or a Weilby procedure—and none had additional procedures to address MCP hyperextension. Pre- and postoperative assessments included pinch and grip strength, degree of MCP hyperextension, and thumb radial and palmar abduction. A t-test was used to assume unequal variances. Results A total of 203 patients were followed for an average of 27.3 months. Patients were divided into two groups: (1) patients without preoperative MCP hyperextension (167 patients) and (2) patients with mild but untreated preoperative MCP hyperextension (≤ 30 degrees; 36 patients). All patients underwent either a Weilby procedure (118 patients) or an LRTI; 85 patients). The main difference between techniques was the use of the abductor pollicis longus tendon as a post to secure the flexor carpi radialis (Weilby) or the use of a bone tunnel in the first metacarpal (LRTI). Analysis of the preoperative data showed no difference in the baseline parameters among both the groups, with the exception of MCP hyperextension. Postoperatively, neither the type of CMC procedure nor the presence of MCP hyperextension demonstrated any significant differences in key pinch, tip pinch, grip strength, and radial or palmar abduction of the thumb between the groups. Conclusion There were no statistically significant differences in improvement of functional outcomes after surgery when comparing patients without preoperative MCP hyperextension to patients with untreated MCP hyperextension of less than 30 degrees. Level of Evidence Level III, retrospective comparative study.

scholarly journals The Influence of Evidence in the Surgical Treatment of Thumb Basilar Joint Arthritis

2013 ◽  
Vol 131 (4) ◽  
pp. 816-828 ◽  
Author(s):  
Oluseyi Aliu ◽  
Matthew M. Davis ◽  
Sonya DeMonner ◽  
Kevin C. Chung
Keyword(s):  
Surgical Treatment ◽  
Joint Arthritis
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