Abstract
BackgroundThe purpose of this study was to introduce arthroscopic partial trapeziectomy and tendon interposition for the treatment of symptomatic thumb carpometacarpal arthritis of Eaton stage II or III.MethodsFrom August 2001 to April 2009, 23 patients with thumb carpometacarpal arthritis were treated using this technique. Pain score, range of motion, and pinch strength were clinically evaluated and compared with the preoperative values after a minimum follow-up duration of 24 months.ResultsSignificant reduction in pain score and increases in range of motion and pinch strength were found (all p < 0.001) after a 2-year follow-up. The mean ± SD (median) postoperative pain score was 1.0 ± 0.7 (1.0) at rest and 1.3 ± 0.9 (1.0) during daily activities. The postoperative range of motion was 19.1° ± 4.2° (20°) for extension and 35.7° ± 7.1° (35.0°) for flexion, and the postoperative pinch strength was 86.5 % ± 19.9 % (90.0 %). No complications were observed in our patient series.ConclusionsArthroscopic partial trapeziectomy and soft tissue interposition could be an alternative treatment method for patients with symptomatic thumb carpometacarpal arthritis of Eaton stage II or III.
Highlights
The purpose of this study was to introduce arthroscopic partial trapeziectomy and tendon interposition for the treatment of symptomatic thumb carpometacarpal arthritis of Eaton stage II or III
We introduced arthroscopic treatment of stage II and III disease to achieve a minimally invasive surgery [13]
Patients with symptomatic Eaton stage II or III thumb CMC joint arthritis based on preoperative radiographs (Fig. 1a) and previous failure of at least 6 months of conservative treatment were included in this study
Summary
The purpose of this study was to introduce arthroscopic partial trapeziectomy and tendon interposition for the treatment of symptomatic thumb carpometacarpal arthritis of Eaton stage II or III. Numerous surgical techniques have been described, including ligament reconstruction and tendon interposition (LRTI) [4], suspensionplasty [5], first metacarpal extension osteotomy [6], arthrodesis [7], hematoma distraction arthroplasty [8], artificial prosthesis replacement [9], osteochondral allografting [10], hemitrapeziectomy [11], complete trapeziectomy [12], arthroscopy [13], The specific types of surgical procedures for thumb CMC joint arthritis are usually divided between those for Eaton stage I and II–IV disease, depending on whether the cartilage of the basal joint remains unaffected or has existing evidence of degeneration [15]
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