Interposition suspension arthroplasty according to Epping versus arthrodesis for trapeziometacarpal osteoarthritis

Surgical Management of Primary Thumb Carpometacarpal Osteoarthritis: A Systematic Review

“…If interposition is performed, autologous tissue interposition seems preferable, because 2 studies (level III and V) showed that nonautologous tissue interposition was associated with increased complications. 18,21 Also in line with previously reviewed articles 11,19,22,23,35,36,38,39 on trapeziectomy with LR and trapeziectomy with LRTI, we found (based on a highlevel, level II randomized trial 27 ) that superiority of trapeziectomy with additional LR or LRTI is not supported by evidence. However, the 3 studies with the highest study classification (level II) all had a mean follow-up of only 12 months and, therefore, possible long-term benefits of LRTI compared to trapeziectomy alone or with TI could not be assessed.…”

“…The previously mentioned studies by Taylor The 3 newly included studies 24,40,44 (Table 3), in combination with the included studies 5,14,15,20,29,34 in the review by Martou et al (Table 2) and the included study 39 in the updated review by Wajon et al in 2009 (Table 2), provide inconclusive and often conflicting findings on CMC arthrodesis compared to other techniques. Nevertheless, the studies do show that thumb CMC arthrodesis is indicated not only for young people with posttraumatic arthritis but also can be used in older patients with stage II and III OA.…”

“…The systematic reviews by Wajon et al 2,7 also concluded, based on 9 included articles 11,19,22,23,[35][36][37][38][39] (Table 2), that trapeziectomy with LRTI demonstrated no superiority over the other techniques compared in those reviews. However, Wajon et al 2,7 reported that trapeziectomy with LRTI had more adverse effects and trapeziectomy alone had fewer (including scar tenderness, tendon adhesion or rupture, sensory change, or complex regional pain syndrome type 1) and, therefore, concluded that trapeziectomy is safer.…”

“…Overall, when evaluating the newly included studies 6,25,27,40 -42 (Table 3) in combination with the studies included in the review by Martou et al 4,16,17,19,28,[29][30][31][32][33][34] (Table 2) and those 11,19,22,23,[35][36][37][38][39] in the reviews by Wajon et al (Table 2), there is no evidence for superiority of trapeziectomy with additional LR or LRTI. The 3 studies with the highest study classification (level II) all had a mean follow-up of only 12 months and, therefore, long-term differences could not be assessed.…”

Outcome of All-Inside Second-Generation Meniscal Repair

“…Given the chondroprotective properties of the meniscus, meniscal preservation and repair are attempted when possible 2,3 . Several meniscal repair techniques, including open, outside-in, inside-out, and all-inside, have been described 4,5 .…”