Outcomes of Surgical Management for Thumb Basilar Arthritis in Patients 55 Years of Age and Younger

Rhee, Peter C.; Paul, Aaron; Carlsen, Brian T.; Shin, Alexander Y.

doi:10.1177/1558944718769378

Cited by 15 publications

(18 citation statements)

References 15 publications

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“… 16 , 17 , 27 Regarding MCP joint mobility, four studies gave preoperative MCP extension values. 16 , 18 , 22 , 28 MCP extension was stable or decreased in three. 18 , 20 , 24 …”

Section: Resultsmentioning

confidence: 90%

“…Three studies with preoperative values reported improvement in the other analyzed sectors. 12 , 16 , 28 Thumb extension (118 T) decreased at final follow-up compared to full extension, with a mean Kapandji score of 2.4 (1.8 to 4; DA: 15%). 16 , 17 , 27 Regarding MCP joint mobility, four studies gave preoperative MCP extension values.…”

Section: Resultsmentioning

confidence: 95%

“…Eight series did not have a radiological assessment or were incomplete. 30 Rhee et al 28 was excluded due the long-term findings overlapping with shorter investigations. Proximal metacarpal migration was measured as the percentage of diminution in the height of the arthroplasty space compared with early postoperative radiographs (trapezial index), the measure between the distal scaphoid pole and the base of the first metacarpal (trapezial height), or calculated by dividing the trapezial space by the proximal phalangeal length to minimize magnification errors (trapezial space ratio ( TSR)).…”

Section: Resultsmentioning

confidence: 99%

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Trapeziectomy for trapeziometacarpal osteoarthritis

Saab

Chick

2021

Bone & Joint Open

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Aims The objective of this systematic review was to describe trapeziectomy outcomes and complications in the context of osteoarthritis of the base of the thumb after a five-year minimum follow-up. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide study design, and 267 full-text articles were assessed for eligibility. After exclusion criteria application, 22 studies were included, involving 728 patients and 823 trapeziectomies. Outcomes included pre- and postoperative clinical and radiological characteristics. Complications and revisions were recorded. Results All the studies reported good results regarding pain and range of motion at the last follow-up of 8.3 years (5 to 22); the mean satisfaction rate was 91% (84% to 100%). It was difficult to assess the impact on metacarpophalangeal joint motion in extension with contrary results. The key pinch returned to its preoperative values, whereas tip pinch showed a modest improvement (+14%), with a mild improvement found in grip strength (+25%) at the last follow-up. The mean progressive trapezial collapse was 48% (0% to 85%) and was not correlated with pain, grip strength, or satisfaction. The most represented complications were linked to tendons or nerves affected during additional procedures to stabilize the joint (11.6%; n = 56). Mechanical complications included symptomatic scapho-M1 impingement (3.1%; n = 15/580), leading to nine surgical revisions out of 581 trapeziectomies. Meta-analysis was not possible due to study heterogeneity and limited data. Conclusion After a minimum five-year follow-up, trapeziectomy achieved high patient satisfaction and pain relief. However, strength seemed to be deteriorating with detrimental consequences, but this did not correlate with trapezial collapse. The issues related to underestimating mechanical complications and varying degrees of success should be highlighted in the information given to patients. Evidence-based analyses should help the surgeon in their decision-making. Cite this article: Bone Jt Open 2021;2(3):141–149.

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“… 16 , 17 , 27 Regarding MCP joint mobility, four studies gave preoperative MCP extension values. 16 , 18 , 22 , 28 MCP extension was stable or decreased in three. 18 , 20 , 24 …”

Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Trapeziectomy for trapeziometacarpal osteoarthritis

Saab

Chick

2021

Bone & Joint Open

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“…It is unclear if the statistically significant difference in age between the cohorts has an effect on the results. Rhee et al 15 looked at the results of trapeziectomy with LRTI or suspensionplasty in patients younger than 55 years. They found improvements in pain and grip strength despite progressive metacarpal subsidence with no revisions at 10 years.…”

Section: Discussionmentioning

confidence: 99%

Radiographic Outcomes in Treatment of Thumb Basal Joint Arthritis: Does Interposition of Acellular Dermal Allograft Prevent Metacarpal Settling?

Khurana

Chen

Brooks

2020

Journal of Hand and Microsurgery

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Background Osteoarthritis at the thumb carpometacarpal joint can have a profound impact on quality of life. Here, we evaluate radiographic outcomes in patients who have had open complete trapeziectomy, ligament reconstruction with tendon interposition, and acellular dermal matrix (GraftJacket) interposition—Group A, and compare them with those without GraftJacket interposition—Group B. Materials and Methods Thirty patients who had undergone operative treatment for thumb basal joint arthritis by a single surgeon from 2009 to 2016 were identified, and charts were retrospectively reviewed for demographic data, surgical and radiographic outcomes, and complications. Results There was no significant difference in pre- and postoperative radial abduction or pre- and postoperative palmar abduction. The difference in intraoperative joint space was significant (p = 0.006), but the difference in postoperative joint space was not (p = 0.310). The average amount of metacarpal settling was 6.9 versus 3.7 mm (p = 0.035) (Groups A and B, respectively). Three patients in Group A developed an inflammatory reaction to the GraftJacket, and one required reoperation for allograft removal. Conclusion This study suggests that thumb basal joint arthroplasty with GraftJacket interposition does not lead to more favorable radiographic outcomes at long-term follow-up. The increased costs associated with GraftJacket use may not be justified in light of these outcomes.

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“…The question of surgical inevitability is difficult to answer. While the overall favorable predictability of surgical intervention is well known, [1][2][3][4] long-term data on the natural history of symptomatic TM arthritis is lacking.…”

Section: Introductionmentioning

confidence: 99%

Trapeziometacarpal joint arthritis: A retrospective study of the natural history of symptomatic thumb arthritis

Frankenhoff

Stromberg

Riley

et al. 2019

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Objective: Trapeziometacarpal (TM) joint arthritis is a common source of hand pain in patients presenting to the hand surgeon’s clinic. Long-term data on the natural history of symptomatic TM arthritis is lacking.Methods: We identified 251 patients with symptomatic TM arthritis and performed a retrospective chart review which identified treatment modalities (including surgery) and long term outcomes which were assessed via a telephone survey.Results: We found that of the 251 patients who presented with symptomatic TM arthritis, the 114 patients who had surgery had less pain and disability in the long term than those patients who were treated conservatively with splinting or injection (average pain score 1.8 vs. 3.8). However, the majority of patients did not ultimately undergo surgery.Conclusions: Although patients fare better from a pain and function standpoint with surgery, surgery is not inevitable.

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Outcomes of Surgical Management for Thumb Basilar Arthritis in Patients 55 Years of Age and Younger

Abstract: Trapeziectomy and LRTI or suspensionplasty in patients less than or equal to 55 years of age can result in considerable improvements in pain and grip strength with a 10-year survivorship free from revision.

Cited by 15 publications

References 15 publications

Trapeziectomy for trapeziometacarpal osteoarthritis

Trapeziectomy for trapeziometacarpal osteoarthritis

Radiographic Outcomes in Treatment of Thumb Basal Joint Arthritis: Does Interposition of Acellular Dermal Allograft Prevent Metacarpal Settling?

Trapeziometacarpal joint arthritis: A retrospective study of the natural history of symptomatic thumb arthritis

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