Trapeziometacarpal joint osteoarthritis: a retrospective study comparing arthrodesis to tendon interposition arthroplasty |
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Authors: | C Rossi P Cellocco F Bizzarri E Margaritondo G Costanzo |
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Institution: | (1) Department of Locomotor System Diseases, University of L’Aquila, Italy;(2) Clinic of Emergency Surgery, Policlinico Umberto I, University La Sapienza, Rome, Italy |
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Abstract: | Abstract
Surgical management of trapeziometacarpal joint osteoarthritis (OA) is still controversial. The aim of this study was to evaluate
and compare results of trapeziometacarpal arthrodesis and of tendon interposition arthroplasty. One hundred twenty-six patients
suffering from trapeziometacarpal OA underwent surgery between 1996 and 2001. Of these patients, 62 (78 thumbs) treated with
joint arthrodesis and 33 (41 thumbs) treated with tendon interposition arthroplasty with abductor pollicis longus (APL) have
been evaluated at follow-up and therefore entered this study. Mean age was 53 years, while the mean follow-up was 36 months.
Overall results were satisfactory in 84 patients with good pain improvement. Patients treated with arthrodesis showed better
functional ability in bi-digital pinch and grip strength. First finger opposition motion, however, was better conserved in
patients treated with interposition arthroplasty. Fusions had an 11.5% complication rate (9 thumbs) with nonunions, whereas
14.8% (6 thumbs) of patients treated with interposition arthroplasty developed 1 first metacarpal base collapse, resulting
in 1 first ray length reduction. Despite complications, however, patients did not report unsatisfactory results and generally
experienced marked pain reduction. This study shows that arthrodesis can be considered the treatment of choice in patients
suffering from trapeziometacarpal OA at Eaton stage III or less, whatever the age and when a good pinch strength is needed. |
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Keywords: | Trapeziometacarpal joint Osteoarthritis Arthrodesis Tendon interposition arthroplasty |
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