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J Wrist Surg 2022; 11(06): 521-527
DOI: 10.1055/s-0042-1744384
Scientific Article

Proximal Trapezoidectomy and Scaphotrapezoid Joint Tendon Interposition at the Time of Ligament Reconstruction and Tendon Interposition for Pan Trapezial Osteoarthritis Does Not Increase Proximal Carpal Row Malalignment

Mark Ross 
1   Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia
2   Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
3   School of Medicine, The University of Queensland, St. Lucia, Queensland, Australia
,
David Gilpin
1   Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia
,
Christopher James
1   Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia
2   Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
,
Susan E. Peters 
4   Harvard Center for Work, Health, and Well-being, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
,
Richard Benson
1   Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia
2   Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
,
Greg Couzens
1   Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia
2   Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
5   Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
,
Bradley Gilpin
1   Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia
2   Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
,
Matthew W.T. Curran 
1   Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia
2   Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
› Author Affiliations
Funding The authors received no financial support for the research, authorship, and/or publication of this article. The Brisbane Hand and Upper Limb Research Institute receives institutional support and fellowship support from Newclip Technics, Johnson & Johnson (DePuy Synthes), Exactech, Integra LifeSciences, and LMT Surgical.
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Abstract

Background Surgical options for osteoarthritis (OA) of the first carpometacarpal include excision, replacement arthroplasty, and arthrodesis. However, in pan trapezial OA, optimal management of residual scaphotrapezoidal articulation has remained unclear.

Purpose The purpose of this study was to evaluate whether removing the proximal trapezoid from the scaphotrapezoid joint (STJ) and interposing tendon when performing a ligament reconstruction and tendon interposition (LRTI) for pan trapezial arthritis resulted in any clinical or radiographic compromise compared with LRTI alone in isolated carpometacarpal joint arthritis.

Methods In a prospective consecutive cohort, 122 thumbs were selected to generate two matched cohorts and a cross-sectional review was completed at an average of 24 months (range: 5–203 months). Fifty-six thumbs had LRTI alone and 66 thumbs also had resection of the proximal portion of the trapezoid with tendon interposition in the residual gap.

Results The cohorts showed no significant differences in subjective and objective outcome measures and imaging. Excision of the STJ was not associated with poorer clinical outcomes or the development of a dorsal intercalated segment instability deformity.

Conclusions The management of pan trapezial arthritis with LRTI and proximal trapezoid excision and STJ interposition appears satisfactory on short- to medium-term clinical and radiographic follow-up.

Level of Evidence: This is a Level III, consecutive cross-sectional cohort study.

Keywords

LRTI - pantrapezial arthritis - partial trapezoidectomy - thumb carpometacarpal arthritis - arthroplasty - scaphotrapeziotrapezoid joint

Ethical Approval

Ethical approval was obtained from the Brisbane Private Hospital Low Risk Ethics Committee (Reference LREC/18/BPH/1).




Publication History

Received: 27 September 2021

Accepted: 04 February 2022

Article published online:
08 June 2022

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