Arthroscopic Resection Arthroplasty for Treatment of Combined Carpometacarpal and Scaphotrapeziotrapezoid (Pantrapezial) Arthritis

Abstract

Arthroscopy of the carpometacarpal (CMC) and scaphotrapeziotrapezoid (STT) joints has been described for the purpose of diagnosing, staging, and treating CMC and STT pathology. This study evaluates the short-term outcome of arthroscopic resection arthroplasty (ARA) for pantrapezial arthritis. Thirty-five cases of ARA of the CMC and STT joints were performed in 34 patients with one year minimum follow-up. There were 27 women and 7 men. Average age was 63 (range, 46 to 79). All patients had simultaneous ARA of both the CMC and STT joints. A 2- to 3-mm section of bone was resected from the proximal and distal aspect of both the CMC and STT joints. Preoperative data collected included 10-point self-reported pain scale, Disabilities of the Arm, Shoulder, and Hand (DASH) outcome measure, range of motion, grip strength, key and chuck pinch, length of symptoms, and treatment. Postoperative data included the same data plus patient satisfaction, graded on a 0 to 5 scale. Data were collected at postoperative months 1, 3, 6, and 12. Average time of postoperative immobilization was less than 3 weeks (range, 2-6). The DASH scores averaged 46 before surgery, and 51, 30, 20, and 19 respectively, for the aforementioned postoperative intervals. The mean improvement in key pinch was 1.3 kg. The mean improvement in grip was 4.3 kg. Pain improved from 7 before surgery to 1 at one-year follow-up. Short-term analysis suggests that ARA for pantrapezial arthritis provides satisfactory pain relief and return of strength and function.