Results of the treatment of first carpometacarpal joint osteoarthritis: trapeziectomy alone versus trapeziectomy associated with suspensionplasty

Barthel, Louis; Díaz, J.J. Hidalgo; Vernet, P.; Gouzou, S.; Igeta, Yuka

doi:10.1007/s00590-018-2173-3

Cited by 13 publications

(19 citation statements)

References 20 publications

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“…The trapeziometacarpal joint (TMJ) is a common site of osteoarthritis, especially in elderly women [1,2]. When non-operative treatment is insufficient, trapeziectomy with ligament reconstruction and tendon interposition (LRTI) still remains the dominant surgical method, although the literature has not shown any advantages compared to simple trapeziectomy [3][4][5][6][7]. The effect of surgical interventions for TMJ osteoarthritis in terms of patient reported outcome measures (PROM) has been assessed with for example the Michigan Hand Outcomes Questionnaire (MHQ) [8], the Patient Evaluation Measure (PEM) [9], and most commonly the Disability of the Arm, Shoulder and Hand (DASH) questionnaire [2,10].…”

Section: Introductionmentioning

confidence: 99%

A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis

Wilcke

Roginski

Åström

et al. 2020

BMC Musculoskelet Disord

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Background: The aim of the study was to evaluate patient reported outcome measures (PROM) before and after trapeziectomy with or without ligament reconstruction and tendon interposition for trapeziometacarpal joint arthritis with special focus on possible differences due to gender, age and surgical method. Methods: Data from the Swedish quality registry for hand surgery (HAKIR) was analyzed preoperatively, 3 months and 1 year postoperatively for 1850 patients (mean age 63 years, 79% women). Results: One year postoperatively, mean pain at rest was reduced from 50 to 12 of maximum 100. However, pain on load and weakness had not abated to the same extent (mean 30 and 34 of 100, respectively). The mean improvement in PROM did not differ between age groups or gender. The result was similar after trapeziectomy with ligament reconstruction and tendon interposition (86% of the patients) and simple trapeziectomy but few patients were operated with the latter method. Conclusion: Pain on load and weakness remains to some extent 1 year after surgery for trapeziometacarpal joint arthritis. The result is similar after trapeziectomy with or without ligament reconstruction and tendon interposition and the same improvement can be expected after surgery regardless of age and gender.

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Section: Introductionmentioning

confidence: 99%

A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis

Wilcke

Roginski

Åström

et al. 2020

BMC Musculoskelet Disord

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“…We identified the following 11 TMO surgical techniques: first metacarpal osteotomy, 48 first metacarpal and trapezium partial resection, 52,71 arthrodesis, 35,40,44,56,57,70e73,81,82 trapeziectomy, 28e32,37,38,53e55,58,60,65,76e78 trapeziectomy with hematoma distraction arthroplasty (HDA), 42,69 trapeziectomy and ligament reconstruction (TþLR), 16,33,36,42,48,49,51,76,84 trapeziectomy and tendon interposition (TþTI), 32,63,71,83,84 trapeziectomy with ligament reconstruction and tendon interposition (TþLRTI), 16,29e33,35,36,38e41,43e47,50,55,59,62e64,66,67,69,70,72,74,78,80e82,85 chondrocostal graft interposition, 58,69 autologous fat injection, 80 and the use of the following manufactured implants: Arex, 61,83 ARPE, 77,85 Artelon, 50,66 De la Caffini ere, 55,75 Elektra, 34,74 Graft-Jacket, 43,52 Guepar, 47 Ivory, 79 Ledoux, 75 Maia, 61 Permacol, 28 Pi 2 , 46,51,54,65 PyroDisk, …”

Section: Resultsmentioning

confidence: 99%

“…We identified 11 categories of surgical techniques: first metacarpal osteotomy, 48 first metacarpal and trapezium partial resection, 52,71 arthrodesis, 35,40,44,56,57,70e73,81,82 trapeziectomy, 28e32,37,38,53e55,58,60,65,76e78 TþHDA, 42,69 TþLR, 16,33,36,42,48,49,51,76,84 TþTI, 32,63,71,83,84 TþLRTI, 16,29e33,35,36,38e41,43e47,50,55,59,62e64,66,67,69,70,72,74,78,80e82,85 chondrocostal graft interposition, 58,69 autologous fat injection, 80 and the use of manufactured implants. 28,34,39,43,46,47,50e56,61,62,64e66,68,70,73e75,77,79,83,85 Pertaining to the efficacy of these surgical techniques, the evidence quality was low at best.…”

Section: Discussionmentioning

confidence: 99%

“…Among 9049 potential studies identified after the bibliographic database search, 68 were eligible ( Fig. 1 ), comprising 10 SRs, 12 , 13 , 14 , 15 , 16 , 23 , 24 , 25 , 26 , 27 18 RCTs, 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 and 40 NRCTs, 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , ...…”

Section: Methodsmentioning

confidence: 99%

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Efficacy of Surgical Interventions for Trapeziometacarpal (Thumb Base) Osteoarthritis: A Systematic Review

Hamasaki

Harris

Bureau

et al. 2021

Journal of Hand Surgery Global Online

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This systematic review (SR) aimed to identify the surgical interventions available for trapeziometacarpal osteoarthritis and document their efficacy on pain, physical function, psychological well-being, quality of life, treatment satisfaction, and/or adverse events. Methods: This PROSPERO-registered SR's protocol was developed based on the Cochrane intervention review methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Among 9049 potential studies identified,1 SR,18 randomized controlled trials, and 40 nonrandomized controlled trials were included. We identified 11 categories of surgical techniques: first metacarpal osteotomy, first metacarpal and trapezium partial resection, arthrodesis, trapeziectomy (T), Tþligament reconstruction (LR), Tþtendon interposition (TI), Tþligament reconstruction and tendon interposition (LRTI), hematoma distraction arthroplasty (HDA), chondrocostal graft interposition, autologous fat injection, and manufactured implant use. These findings supported by low-quality evidence revealed moderately or largely superior effects of the following interventions: (1) trapeziectomy over TþLRTI using ½ flexor carpi radialis (FCR) and metacarpal tunnel (MT) or using abductor pollicis longus (APL) and FCR for adverse events; (2) trapeziectomy over TþTI using palmaris longus (PL) for pain; (3) TþLR with ½FCR-MT over TþLRTI with ½FCR-MT for physical function; (4) trapeziectomy by anterior approach over that by posterior approach for treatment satisfaction and adverse events; (5) TþLRTI using ½FCR-MTover TþTI with PL for pain; and (6) TþHDA over TþLR using APL-MT-FCR for pain, physical function, and adverse events. GraftJacket (Wright Medical Group, Memphis, TN), Swanson (Wright Medical Group, Letchworth Garden City, UK), and Permacol (Tissue Science Laboratories, Aldershot, UK) implants and hardware (plate/screw) would cause more complications than an autograft. The effect estimates of other surgical procedures were supported by evidence of very low quality. Conclusions: This SR provided evidence of the efficacy of various surgical interventions for trapeziometacarpal osteoarthritis. Some interventions showed a moderate-to-large superior effect on the studied outcome(s) compared with others. However, these findings must be interpreted with caution because of low-quality evidence. To provide stronger evidence, more randomized controlled trials and methodological uniformization are needed. Type of study/level of evidence: Therapeutic I.

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“…Many different surgical treatments have been described to treat thumb CMC arthritis, but few have intermediate or long-term outcome data available, equipoise remains with respect to which treatment is favorable. 10,12 In 1995, Tomaino et al 19 studied 24 thumbs in 22 patients who underwent LRTI (22 using the FCR and 2 using the APL). 17 At a mean follow-up of 9 years (minimum followup of 8 years), they observed excellent and stable functional and radiographic outcomes.…”

Section: Discussionmentioning

confidence: 99%

Intermediate-Term Outcomes of Trapeziectomy With a Modified Abductor Pollicis Longus Suspension Arthroplasty

Earp

Mora

Silver

et al. 2019

Journal of Hand Surgery Global Online

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There is limited literature characterizing intermediate-term surgical and clinical outcomes of basal thumb arthritis after trapeziectomy and modified abductor pollicis longus suspension arthroplasty (APLSA). We hypothesized that patients who underwent APLSA would have favorable intermediate-term outcomes. Methods: Patients were contacted after APLSA at a median follow-up of 4.8 years (interquartile range, 3.0 e6.0 years). Follow-up clinical evaluation included grip, key pinch, and tip pinch strength. We obtained patient-reported outcomes surveys: visual analog pain score and Disabilities of the Arm, Shoulder, and Hand score. Information on demographics, surgical information, and complications was obtained from the electronic medical record and patient interviews. Results: This study evaluated 66 hands in 60 patients (51 women and 9 men, average age 60.4 years at surgery). At the time of index surgery, 8% of hands had prior ipsilateral surgery (not involving the carpometacarpal joint), 56% had concurrent ipsilateral surgery (35% carpal tunnel release, 32% hemitrapezoid resection, 22% other soft tissue procedures (mucous cyst excision, ganglion cyst excision, or trigger finger release), 5% metacarpal capsulodesis, and 5% metacarpal arthrodesis. Median time between operation and most recent evaluation was 4.8 years (interquartile range, 3.0e6.0 years). Operative hand grip (18.7 ± 11.1 kg), key pinch (4.7 ± 2.1 kg), and tip pinch (3.2 ± 1.7 kg) strength was 94%, 84%, and 86%, respectively, of nonsurgical grip, key pinch, and tip pinch strength. Median (interquartile range) outcomes were a visual analog pain score of 0.0 (0.0e2.0) and Disabilities of the Arm, Shoulder, and Hand score of 9.1 (2.3e26.1). Conclusions: Results at 4.8 years for APLSA demonstrated 84% to 94% grip, key pinch, and tip pinch compared with the contralateral side. Patients experienced little to no pain in the operated joint and minimal disability of the upper extremity at intermediate-term follow-up. Abductor pollicis longus suspension arthroplasty is a favorable procedure for achieving pain relief and functional use associated with basal thumb arthritis. Type of study/level of evidence: Prognostic IV.

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Results of the treatment of first carpometacarpal joint osteoarthritis: trapeziectomy alone versus trapeziectomy associated with suspensionplasty

Abstract: Our results suggest that it is unnecessary to perform a ligamentoplasty when a trapeziectomy is indicated.

Cited by 13 publications

References 20 publications

A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis

A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis

Efficacy of Surgical Interventions for Trapeziometacarpal (Thumb Base) Osteoarthritis: A Systematic Review

Intermediate-Term Outcomes of Trapeziectomy With a Modified Abductor Pollicis Longus Suspension Arthroplasty

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