Arthroscopic Debridement and Synovectomy for Treating Basal Joint Arthritis

Abstract

To determine whether arthroscopic debridement and synovectomy of the thumb carpometacarpal joint improves subjective and objective outcomes in patients with stage I and stage II basal joint arthritis. Twenty-three patients with stage I or stage II basal joint arthritis were treated with arthroscopic synovectomy and joint debridement. Twenty-one age- and gender-matched patients were treated with additional forms of nonoperative therapy (control group). Change in visual analog scale (VAS), Disabilities of the Arm, Shoulder and Hand (DASH), and subjective scores and change in pinch strength were evaluated 12 months after treatment. The pretreatment mean VAS, DASH, and subjective scores for the surgical and control groups were 7.7 and 7.5, respectively (P = .3); 55.6 and 54.4, respectively (P = .3); and 4 and 4, respectively (P = .9). At follow-up, the mean VAS, DASH, and subjective scores for the surgical and control groups were 2.7 and 7.3, respectively (P < .001); 26 and 53.1, respectively (P < .001); and 1.8 and 3.8, respectively (P < .001). At follow-up, mean pinch strength for the surgical and control groups was 6.2 +/- 1.3 kg and 4.9 +/- 1.1 kg, respectively (P < .001). Eighty-three percent of the surgical patients reported their result as either good or excellent. There were no significant complications. This study shows that arthroscopic debridement and synovectomy improve pain scores, functional scores, subjective outcome, and pinch strength more so than traditional nonoperative therapy.