D6. Significance and Implications of Partial Trapezoidectomy in Management of Scapho-Trapezio-Trapezoid (STT) Osteoarthritis

Abstract

PURPOSE: Trapeziectomy with partial trapezoid excision is a common surgical approach for scapho-trapezio-trapezoidal osteoarthritis (STTOA). This study seeks to determine the efficacy of partial trapezoidectomy for the treatment of STTOA. METHODS: All patients within the Cleveland Clinic Healthcare System who received a trapeziectomy with or without partial trapezoidectomy for isolated STTOA between 2003 and 2022 were reviewed. Demographic information, pain scores, and physical findings were recorded. Second metacarpal subsidence was calculated as a ratio of the change in scaphotrapezoid space (base of second metacarpal to scaphoid) preoperatively and postoperatively over the preoperative scaphotrapezoid space. Differences in subsidence and correlation between subsidence and pain scores were assessed between the two groups. RESULTS: Sixty-seven patients who underwent 76 trapeziectomies were included. Of these, 37 underwent a partial trapezoidectomy. The average age at the time of surgery was 64 years (48-86), and 58 patients were female. Median follow-up time was 3 months (IQR=3). 81% of patients with partial trapezoidectomy had second metacarpal subsidence with a median subsidence of 14%(IQR=18), compared to 72% of patients in the trapeziectomy only group who had a median subsidence of 15%(IQR=30) (p=0.34). Pain scores decreased from 6 to 2 in the partial trapezoidectomy group (p<0.001) and from 7 to 3 in the trapeziectomy only group (p<0.001). There was no significant correlation between subsidence and pain in either group (p=0.301, p=0.729). CONCLUSION: Trapeziectomy with and without partial trapezoidectomy reduced pain, but neither procedure was more effective than the other. Subsidence was not found to be a significant indicator of postoperative pain.