J Hand Microsurg 2020; 12(01): 43-46
DOI: 10.1055/s-0039-1698356
Original Article

Mid-Term Results of Partial Trapeziectomy and Simple FCR Tendon Graft Interposition in a Selected Group of Patients with Thumb Carpometacarpal Joint Arthritis

1   Department of Surgery, King Saud University, Riyadh, Saudi Arabia
2   Division of Plastic Surgery, Department of Surgery, National Guard Health Affairs, Riyadh, Saudi Arabia
,
Saad A. Al Mohrij
3   Department of Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
› Author Affiliations
Funding The work was supported by the College of Medicine Research Center, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.

Abstract

Introduction There are several surgical options for the treatment of osteoarthritis of the first carpometacarpal joint (CMCJ1). We introduce our technique of partial trapeziectomy and flexor carpi radialis (FCR) tendon graft interposition in a selected group of patients with CMCJ1.

Objective The main purpose of this article is to investigate the mid-term results of our technique.

Patients and Methods This is a retrospective study of 24 patients with CMCJ1 arthritis (23 females and 1 male with a mean age of 68 years) who were treated with partial trapeziectomy and simple FCR tendon graft interposition. Patient selection for this procedure was based on two prerequisites: the absence of scaphotrapezial arthritis and the absence of severe ligament laxity or severe subluxation of the CMCJ1. All patients had a mean follow-up of 6 years. Pre- and postoperative standard assessments were done.

Results There were no postoperative complications and a zero-revision rate. All parameters significantly improved after surgery (p < 0.05). All patients were “very satisfied” with the outcome.

Conclusion The procedure of partial trapeziectomy and FCR tendon graft interposition can give an excellent mid-term outcome with a zero-revision rate if utilized in a selected group of patients with CMCJ1 arthritis.



Publication History

Received: 05 May 2019

Accepted: 09 August 2019

Article published online:
22 November 2019

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Thieme Medical and Scientific Publishers Private Ltd.
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  • References

  • 1 Matullo KS, Ilyas A, Thoder JJ. CMC arthroplasty of the thumb: a review. Hand (N Y) 2007; 2 (04) 232-239
  • 2 Gillis J, Calder K, Williams J. Review of thumb carpometacarpal arthritis classification, treatment and outcomes. Can J Plast Surg 2011; 19 (04) 134-138
  • 3 Blount AL, Armstrong SD, Yuan F, Burgess SD. Porous polyurethane urea (Artelon) joint spacer compared to trapezium resection and ligament reconstruction. J Hand Surg Am 2013; 38 (09) 1741-1745
  • 4 Putnam MD, Meyer NJ, Baker D, Brehmer J, Carlson BD. Trapezium excision and suture suspensionplasty (TESS) for the treatment of thumb carpometacarpal arthritis. Tech Hand Up Extrem Surg 2014; 18 (02) 102-108
  • 5 Menon J. Arthroscopic management of trapeziometacarpal joint arthritis of the thumb. Arthroscopy 1996; 12 (05) 581-587
  • 6 Gray KV, Meals RA. Hematoma and distraction arthroplasty for thumb basal joint osteoarthritis: minimum 5-year follow-up evaluation. J Hand Surg Am 2007; 32 (01) 23-29
  • 7 Naram A, Lyons K, Rothkopf DM. et al. Increased complications in Trapeziectomy with ligament reconstruction and tendon interposition compared with trapeziectomy alone. Hand (N Y) 2016; 11 (01) 78-82
  • 8 Eaton RG, Lane LB, Littler JW, Keyser JJ. Ligament reconstruction for the painful thumb carpometacarpal joint: a long-term assessment. J Hand Surg Am 1984; 9 (05) 692-699
  • 9 Kapandji A. [Clinical test of apposition and counter-apposition of the thumb]. Ann Chir Main 1986; 5 (01) 67-73
  • 10 Hudak PL, Amadio PC, Bombardier C. The Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. Am J Ind Med 1996; 29 (06) 602-608
  • 11 Dahaghin S, Bierma-Zeinstra SM, Ginai AZ, Pols HA, Hazes JM, Koes BW. Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Ann Rheum Dis 2005; 64 (05) 682-687
  • 12 Marks M, Hensler S, Wehrli M, Scheibler AG, Schindele S, Herren DB. Trapeziectomy with suspension-interposition arthroplasty for thumb carpometacarpal osteoarthritis: a randomized controlled trial comparing the use of allograft versus flexor carpi radialis tendon. J Hand Surg Am 2017; 42 (12) 978-986
  • 13 Scheker L, Boland MR. Dynamic suspension-sling arthroplasty with intermetacarpal ligament reconstruction for the treatment of trapeziometacarpal osteoarthritis. Eur J Plast Surg 2004; 27 (04) 185-193
  • 14 Wouters RM, Tsehaie J, Hovius SER, Dilek B, Selles RW. Post-operative rehabilitation following thumb base surgery. A systematic review of literature. Arch Phys Med Rehabil 2018; 99 (06) 1177-1212
  • 15 Pieron AP. The mechanism of the first carpometacarpal (CMC) joint. An anatomical and mechanical analysis. Acta Orthop Scand Suppl 1973; 148: 1-104
  • 16 Tomaino MM, Pellegrini Jr VD, Burton RI. Arthroplasty of the basal joint of the thumb. Long-term follow-up after ligament reconstruction with tendon interposition. J Bone Joint Surg Am 1995; 77 (03) 346-355