Comparison of Trapeziectomy and Trapeziectomy with Ligament Reconstruction and Tendon Interposition: A Systematic Literature Review

Li, Yu Kit; White, Colin; Ignacy, Teegan A.; Thoma, Achilleas

doi:10.1097/prs.0b013e318217435a

Cited by 71 publications

(42 citation statements)

References 46 publications

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“…The trapeziometacarpal joint of the thumb is commonly affected by osteoarthritis, second in frequency in the hand only to the distal interphalangeal joint, and it affects 1 in 4 women and 1 in 12 men [15,19,20,24]. It is the most common site for surgery in the hand when surgery is sought to treat an arthritic condition [20].…”

Section: Introductionmentioning

confidence: 99%

Locking Plate Arthrodesis Compares Favorably with LRTI for Thumb Trapeziometacarpal Arthrosis: Early Outcomes from a Longitudinal Cohort Study

Kazmers

Hippensteel

Calfee

et al. 2017

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Trapeziometacarpal arthrodesis (TMA) has been complicated by nonunion and hardware failure. Questions/Purposes: We hypothesized that modification of the TMA technique with a locking cage plate construct would afford reliable bony union while producing greater hand function than trapeziectomy with ligament reconstruction and tendon interposition (LRTI) at early follow-up. Methods: We enrolled 36 consecutive patients with trapeziometacapal osteoarthritis (14 TMA patients (15 thumbs), 22 LRTI patients (22 thumbs)). The study was powered to detect a minimal clinically important difference on the QuickDASH questionnaire between groups. Secondary outcomes included Michigan Hand Questionnaire (MHQ), VAS-pain, and EQ-5D-3L scores. Patients were examined to evaluate thumb motion and strength. TMA patients were evaluated clinically and radiographically for union. Results: Mean follow-up was 15.6 months, and the mean age was 59.2 years. Union was achieved in 14/15 (93%) of TMA thumbs. Improvement in QuickDASH scores was similar after TMA and LRTI (49 to 28 and 50 to 18, respectively). Postoperative patient-rated upper extremity function, health status, and pain were similar between groups. Pinch strength was significantly greater after TMA (5.9 vs 4.7 kg). No differences in thumb or wrist range of motion were observed postoperatively with the exception of greater total metacarpophalangeal joint motion after TMA. Complications after TMA included nonunion (7%), development of symptomatic scaphotrapezotrapezoidal (STT) arthrosis (7%), symptomatic hardware (7%), and superficial branch of the radial nerve (SBRN) paresthesia (7%). Complications after LRTI included subsidence (5%), MP hyperextension deformity (5%), and SBRN paresthesias (5%). Conclusions: At early follow-up, patient-rated function was similar among patients undergoing TMA and LRTI. TMA produced 25% greater pinch strength compared with LRTI. Despite historical concerns regarding global loss of ROM with arthrodesis, motion was similar between groups. Our observed TMA nonunion rate of 7% is low relative to historically reported nonunion rates (7-16%). Locking cage plate technology affords rigid fixation for TMA with promising early results noting reliable bony union while minimizing complications.

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Section: Introductionmentioning

confidence: 99%

Locking Plate Arthrodesis Compares Favorably with LRTI for Thumb Trapeziometacarpal Arthrosis: Early Outcomes from a Longitudinal Cohort Study

Kazmers

Hippensteel

Calfee

et al. 2017

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…Postoperative thumb exercise protocols were quite variable across the studies identified (Table 4). Some patients simply were shown exercises after the immobilization was discontinued [2,5,8,12,13,15,19]. Patients in other studies were referred to a therapist after the period of immobilization [1,3,4,7,9,24].…”

Section: Resultsmentioning

confidence: 99%

“…In studies in which patients underwent trapeziectomy followed by either tendon interposition or ligament reconstruction, the duration of splinting or casting ranged from 4 to 8 weeks. A common theme in studies in which a Kirschner wire was used after the surgical procedure [3,6,14,15] was that patients were casted or splinted at least until the wire was removed, which occurred 4 to 5 weeks after surgery. For the studies in which some sort of joint prosthesis was implanted [1,9,18,20,21,24], postoperative immobilization time ranged from 2 to 6 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…These include resection of the trapezium with or without Kirschner wire stabilization of the thumb metacarpal, basal joint arthroplasty with trapezium resection, ligament reconstruction and tendon interposition, and prosthetic replacement. Although many systematic reviews have compared the various surgical procedures for treatment of basal joint arthritis [15,17,25]. These procedures generally are followed by postoperative therapy regimens, which can be quite variable.…”

Section: Introductionmentioning

confidence: 99%

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A Systematic Review of Postoperative Hand Therapy Management of Basal Joint Arthritis

Wolfe

Chu

Woods

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background There are a variety of postoperative immobilization and therapy options for patients with basal joint arthritis. Although prior systematic reviews have compared surgical procedures used to treat basal joint arthritis, none to our knowledge compares therapy protocols for this condition, which are considered an important part of the treatment.Questions/purposes (1) We sought to determine whether differences in the length and type of postoperative immobilization affect clinical results after basal joint arthritis surgery. (2) We also compared specific therapy protocols that were prescribed. (3) Finally, we evaluated published protocols to determine when patients were released to full activity to see whether these appeared to affect clinical results. Methods A systematic review of English-language studies in the PubMed and Cochrane databases was performed. Studies were then reviewed to determine what postoperative immobilization and therapy protocols the authors used and when patients were released to full activities. A total of 19 studies were identified using the search criteria.

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“…The senior author stopped performing routine ligament reconstruction and tendon interposition (LRTI) and K-wire insertion 3 years ago as a result of best evidence literature assessment [1,8,11]. Since then, they have observed that the results are comparable to LRTI or trapeziectomy with K-wire, but that the patient morbidity is less, as the high-level evidence suggests.…”

Section: Surgical Approach For Basal Joint Trapeziectomymentioning

confidence: 95%

Wide-Awake Trapeziectomy: Video Detailing Local Anesthetic Injection and Surgery

Farhangkhoee

Lalonde

2011

Hand (New York, N,Y.)

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Comparison of Trapeziectomy and Trapeziectomy with Ligament Reconstruction and Tendon Interposition: A Systematic Literature Review

Abstract: Therapeutic, II.(Figure is included in full-text article.).

Cited by 71 publications

References 46 publications

Locking Plate Arthrodesis Compares Favorably with LRTI for Thumb Trapeziometacarpal Arthrosis: Early Outcomes from a Longitudinal Cohort Study

Locking Plate Arthrodesis Compares Favorably with LRTI for Thumb Trapeziometacarpal Arthrosis: Early Outcomes from a Longitudinal Cohort Study

A Systematic Review of Postoperative Hand Therapy Management of Basal Joint Arthritis

Wide-Awake Trapeziectomy: Video Detailing Local Anesthetic Injection and Surgery

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