Ligament Reconstruction Arthroplasty for Primary Thumb Carpometacarpal Osteoarthritis (Weilby Technique): Prospective Cohort Study

Vermeulen, Guus M.; Brink, Sander M.; Sluiter, J.; Elias, Sjoerd G.; Hovius, Steven E.R.; Moojen, Thybout M.

doi:10.1016/j.jhsa.2009.06.019

Cited by 55 publications

(30 citation statements)

References 24 publications

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“…In our study, the mean DASH score at a mean of 18.5 months postoperatively was 11.79. Compared with the combined mean preoperative DASH score from five previous studies (DASH score 51.87, range 43 to 61), this was a mean decrease of 40.08 points (13)(14)(15)(16)(17). When compared with the normative value from an American population (n=1700) studied by the American Academy of Orthopedic Surgeons (18) (10.1±14.68), our average DASH score was only slightly higher.…”

Section: Discussioncontrasting

confidence: 58%

Early outcomes of arthroplasty of the first carpometacarpal joint using pyrocarbon spherical implants

Bengezi

2014

CAN J PLAST SURG

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Section: Discussioncontrasting

confidence: 58%

Early outcomes of arthroplasty of the first carpometacarpal joint using pyrocarbon spherical implants

Bengezi

2014

CAN J PLAST SURG

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“…Complications associated with arthrodesis include nonunion with rates of 7-16% cited in the literature [3,10,11,14,29], hardware complications [22], and a potential predisposition to arthritis at adjacent joints [11] with additional concerns for loss in range of motion and an inability to flatten the hand [14,21]. Alternatively, criticisms associated with trapeziectomy include potential shortening of the first ray, which can lead to decreased thumb strength as well as subluxation or painful arthritis of the pseudarthrosis between the base of thumb metacarpal and the scaphoid [5,6,15,23,30]. Even with a loss in scaphometacarpal height seen in trapeziectomy alone when compared with LRTI, short-term follow-up studies have found no difference in pain/function scores or grip/pinch strength [6,9,19,24].…”

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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“…Our ROM in palmar (60 8 ) and radial (55 8 ) abduction at the final follow-up showed equivalence to series in the literature, which reported similar parameters. 16,21,22,27 In a prospective cohort study, which was published by Vermeulen et al, 28 palmar abduction was stated as an intermetacarpal distance measurement in centimeters rather than goniometric evaluation. Preoperative 5.4-cm measurement in distance was significantly improved to 5.9 cm at 12th months after the surgery.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation Protocol after Suspension Arthroplasty of Thumb Carpometacarpal Joint Osteoarthritis

Ataker

Güdemez

Ece

et al. 2012

Journal of Hand Therapy

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Ligament Reconstruction Arthroplasty for Primary Thumb Carpometacarpal Osteoarthritis (Weilby Technique): Prospective Cohort Study

Cited by 55 publications

References 24 publications

Early outcomes of arthroplasty of the first carpometacarpal joint using pyrocarbon spherical implants

Early outcomes of arthroplasty of the first carpometacarpal joint using pyrocarbon spherical implants

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

Rehabilitation Protocol after Suspension Arthroplasty of Thumb Carpometacarpal Joint Osteoarthritis

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