Traitement arthroscopique de la rhizarthrose – Résultats cliniques

Abstract

TMC joint arthritis is the most common cause of disability of the thumb. The thumb has a very important role in the hand's fine motor skills, as a result, this pathology is associated with significant disability. The arthroscopic treatment of TMC arthritis has presented very promising results in the early stages of the disease. The objective of the present study is to present the results of partial arthroscopic trapezectomy and sinovectomy for the treatment of patients with stage I and stage II TMC arthritis (according to the classification by Eaton and Littler). Twenty-one cases were identified, with an average of 62 years of age and 2 years of follow-up. In 40 % of cases, the TMC arthritis affected the dominant limb. All cases were evaluated regarding pain, ability to perform activities of daily living (ADL), mobility, grip strength, disability (QuickDASH Score) and the degree of patient satisfaction with the procedure. All evaluated parameters registered an improvement. Pain decreased from an average preoperative value of 8.4 (visual analog scale–VAS) to a postoperative average of 1.0. There were improvements regarding the ability to perform ADL, range of motion, grip strength, and disability measured through the QuickDASH score. The average preoperative disability score was 45.5 points, increasing to 8.6 points in the postoperative. There were 4 cases of transient paresthesias in the portal area, which completely disappeared within 12 weeks, in the longest case. The arthroscopic treatment of TMC arthritis is a safe surgical technique, with a high success rate. There were measurable improvements in all the evaluated parameters. The results of the present series are in line with previously published results with the same technique. This fact reinforces the importance of arthroscopy for the treatment of TMC arthritis. The use of arthroscopy for the treatment of TMC arthritis is a relatively recent concept, but the published results are very promising. There is a need for further studies and randomized clinical trials with a longer follow-up in order to establish its role in the treatment of this pathology.