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Thumb osteoarthritis

Anne J Spaans, L Paul van Minnen, Assa Braakenburg, Aebele B Mink van der Molen
OBJECTIVE: The purpose of this pilot study was to evaluate the feasibility of joint distraction of the first carpometacarpal (CMC1) joint in patients with CMC1 osteoarthritis (OA). METHODS: An external joint distractor was placed over the CMC1 joint by K-wire fixation in the trapezium and the metacarpal. The joint was distracted 3 mm during surgery. The device was then kept in place for 8 weeks. Disabilities of the Arm, Shoulder, and Hand (DASH) score, Michigan Hand Outcome Questionnaire (MHQ), Visual Analogue Scale (VAS), and grip strength were recorded preoperatively and at set postoperative intervals...
October 19, 2016: Journal of Plastic Surgery and Hand Surgery
E Kollig, D Bieler, A Franke
The role of joint replacement in the treatment of osteoarthritis of the thumb carpometacarpal joint is a subject of considerable controversy in the current literature. In German-speaking countries this technique is used much less frequently than resection procedures. Aseptic loosening of the prosthesis is believed to be the major cause of the high failure rates reported for cemented and uncemented types of implants. In this study the different implant designs were evaluated on the basis of the results reported in the international literature...
October 13, 2016: Der Unfallchirurg
Thomas Christensen, Shumaila Sarfani, Alexander Y Shin, Sanjeev Kakar
Background: The purpose of this study is to evaluate long-term outcomes of ligamentous repair rather than reconstruction for chronic thumb ulnar collateral ligament (UCL) injuries. Methods: Patients at least 15-years status-post repair of a chronic (greater than 6 weeks) UCL tear were contacted for clinical evaluation, radiographs, and postoperative outcome questionnaires, including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) pain scale, and study-specific questions...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
T Lögters, S Gehrmann, J Windolf
In patients with carpometacarpal osteoarthritis of the thumb, treatment strategies should be based on functional impairment and pain. Although X‑ray imaging is an integral component of the diagnostics, it is of subordinate importance for the therapy algorithm. Conservative therapy is always the first step in the chain of treatment. The efficacy of non-operative treatment, including intermittent immobilization using splinting and the application of technical assist devices in the daily routine has been proven to achieve pain relief...
September 30, 2016: Der Unfallchirurg
K Valdes, Nancy Naughton, Lori Algar
STUDY DESIGN: Systematic review. INTRODUCTION/PURPOSE: The purpose of this study was to systematically review outcome measures used for assessment of orthotic intervention in the conservative management of thumb carpometacarpal osteoarthritis to determine if they characterize International Classification of Functioning, Disability, and Health (ICF) components. The determinants of patient satisfaction regarding the orthotic intervention were also extracted from the studies...
September 20, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Mokhtar Arazpour, Mohaddeseh Soflaei, Monireh Ahmadi Bani, Seyed Pezhman Madani, Mahsa Sattari, Akbar Biglarian, Zahra Mosallanezhad
BACKGROUND: When the first carpometacarpal joint of the wrist is immobilized using an orthosis to combat the effects of osteoarthritis, atrophy of the thenar muscles may occur. OBJECTIVES: The aim of this study was to evaluate the thenar muscle diameter and cross-sectional area, joint function, and pain, before and after being supplied with an orthosis in patients with grades 1 and 2 carpometacarpal osteoarthritis compared to a control group. STUDY DESIGN: Randomized clinical trial...
September 19, 2016: Prosthetics and Orthotics International
I M Mehling, K Schillo, A Arsalan-Werner, J Seegmüller, A C Langheinrich, M Sauerbier
Fractures of the first thumb ray are common and need accurate differential treatment to restore gripping hand functions. Displaced fractures of the distal and proximal phalanx of the thumb are often treated with screws or Kirschner wires. Stable fractures can also be treated non-operatively. Fractures of the base of the first metacarpal should be differentiated into extra-articular Winterstein fractures and intra-articular Bennett or Rolando fractures. Traction forces by the abductor pollicis longus tendon regularly lead to displacement of the shaft of the first metacarpal; therefore, these fractures usually require reduction and fixation...
September 14, 2016: Der Unfallchirurg
Mohammad Umar Mumtaz, Fiaz Ahmad, Altaf Ahmad Kawoosa, Imtiyaz Hussain, Iftikhar Wani
INTRODUCTION: Rolando fractures being intra-articular fractures of the most mobile joint of the thumb, assume significance because any residual incongruity of the articular surface may result in loss of motion as well as secondary osteoarthritis and hence serious disability. This fracture continues to pose difficulties to the treating surgeons and although several treatment options have been described for these fractures, there are no definite guidelines. METHODS: The present study describes the results of open reduction and internal fixation of nine Rolando fractures with large and single fragments, using mini T-plate and screws...
August 2016: Journal of Hand and Microsurgery
Pedro Henrique Tq de Almeida, Joy MacDermid, Tatiana Barcelos Pontes, Clarissa Cardoso Dos Santos-Couto-Paz, João Paulo Chieregato Matheus
BACKGROUND: Orthoses are a well-known intervention for the treatment of thumb osteoarthritis; however, there is a multitude of orthotic designs and not enough evidence to support the efficacy of specific models. OBJECTIVE: To examine the influence of different orthoses on pain, hand strength, and hand function of patients with thumb osteoarthritis. STUDY DESIGN: Literature review. METHODS: A scoping literature review of 14 publications reporting orthotic interventions for patients with thumb osteoarthritis was conducted...
September 9, 2016: Prosthetics and Orthotics International
Priscilla D'agostino, Benjamin Dourthe, Faes Kerkhof, Filip Stockmans, Evie E Vereecke
The thumb plays a crucial role in basic hand function. However, the kinematics of its entire articular chain have not yet been quantified. Such investigation is essential to improve our understanding of thumb function and to develop better strategies to treat thumb joint pathologies. The primary objective of this study is to quantify the in vivo kinematics of the trapeziometacarpal (TMC) and scaphotrapezial (ST) joints during flexion and adduction of the thumb. In addition, we want to evaluate the potential coupling between the TMC and ST joints during these tasks...
September 8, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Kim R Spekreijse, Ruud W Selles, Muhammed A Kedilioglu, Harm P Slijper, Reinier Feitz, Steven E Hovius, Guus M Vermeulen
PURPOSE: To compare the long-term outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) with trapeziometacarpal arthrodesis for osteoarthritis (OA) of the basal thumb joint. METHODS: Patients were evaluated for pain, daily functioning, strength, and complications after a mean follow-up of 5.3 years. Generalized estimating equations statistics were used to compare repeated measurements over time in both groups. RESULTS: After 5 years, patients who had trapeziectomy with LRTI had significantly better pain reduction and function than the arthrodesis group...
September 2016: Journal of Hand Surgery
Marie-Lyne Grenier, Rochelle Mendonca, Peter Dalley
STUDY DESIGN: The study was a retrospective cohort analysis for a 19-month period from May 2013 to December 2014. INTRODUCTION: Although the use of orthoses has long been a staple of conservative treatment measures for individuals with osteoarthritis of the thumb carpometacarpal (CMC) joint, there remains little evidence exploring its effectiveness in improving functional outcomes for this client population. PURPOSE OF THE STUDY: The purpose of this study was to assess the effectiveness of 3 frequently used orthoses in improving the functional pinch strength of adults with a diagnosis of thumb CMC joint osteoarthritis...
July 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Markus Loibl, Siegmund Lang, Lena-Marie Dendl, Michael Nerlich, Peter Angele, Sebastian Gehmert, Michaela Huber
A positive effect of intra-articular platelet-rich plasma (PRP) injection has been discussed for osteoarthritic joint conditions in the last years. The purpose of this study was to evaluate PRP injection into the trapeziometacarpal (TMC) joint. We report about ten patients with TMC joint osteoarthritis (OA) that were treated with 2 intra-articular PRP injections 4 weeks apart. PRP was produced using the Double Syringe System (Arthrex Inc., Naples, Florida, USA). A total volume of 1.47 ± 0.25 mL PRP was injected at the first injection and 1...
2016: BioMed Research International
Massimo Corain, Nicola Zampieri, Raffaele Mugnai, Roberto Adani
BACKGROUND: Various surgical techniques were reported with excellent result for the treatment of trapeziometacarpal joint arthritis. However, the best treatment option was not defined yet. METHODS: This randomized prospective study compared the result of two surgical techniques: tendon interposition arthroplasty (64 patients) and K. wire distraction (56 patients) after trapeziectomy for stage 3 or 4 osteoarthritis of the trapeziometacarpal joint. RESULTS: After a mean follow-up period of 6...
February 2016: J Hand Surg Asian Pac Vol
Zina Model, Andrew Y Liu, Lana Kang, Scott W Wolfe, Jayme C Burket, Steve K Lee
BACKGROUND: We compare the ability of 3 diagnostic tests to reproduce the pain of basilar joint arthritis (BJA): the grind test, the lever test (grasping the first metacarpal just distal to the basal joint and shucking back and forth in radial and ulnar directions), and the metacarpophalangeal extension test. METHODS: Sixty-two patients with thumb BJA were enrolled. The 3 tests were performed in a random order on both hands of each patient. Prior to testing, patients reported their typical pain level and subsequently rated their pain after each test on a 0 to 10 scale, also specifying the extent to which the test reproduced their thumb pain (fully, partially, not at all)...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Genevieve Landes, Michael P Gaspar, Peter Goljan, Sidney M Jacoby, Abdo Bachoura, Randall W Culp
BACKGROUND: Arthroscopic trapeziectomy with suture button suspensionplasty (ATBS) is a relatively new surgical option for the treatment of thumb carpometacarpal (CMC) osteoarthritis. Although ATBS has many potential benefits over alternative surgical treatments for CMC arthritis, little data exist regarding its safety and complication rates. The purpose of this study was to demonstrate that ATBS is associated with a low risk of complications within 1 year of surgery. METHODS: A retrospective review of patients treated with ATBS by one senior hand surgeon over a span of 3 years was performed...
June 2016: Hand: Official Journal of the American Association for Hand Surgery
Jennifer A Nichols, Michael S Bednar, Wendy M Murray
The utility of biomechanical models and simulations to examine clinical problems is currently limited by the need for extensive amounts of experimental data describing how a given procedure or disease affects the musculoskeletal system. Methods capable of predicting how individual biomechanical parameters are altered by surgery are necessary for the efficient development of surgical simulations. In this study, we evaluate to what extent models based on limited amounts of quantitative data can be used to predict how surgery influences muscle moment arms, a critical parameter that defines how muscle force is transformed into joint torque...
2016: PloS One
Alexander Kaltenborn, Elke Bulling, Mirko Nitsche, Ulrich Martin Carl, Robert Michael Hermann
The purpose of this work was to evaluate the efficacy of low-dose radiotherapy (RT) for thumb carpometacarpal osteoarthritis (rhizarthrosis). The responses of 84 patients (n = 101 joints) were analyzed 3 months after therapy (n = 65) and at 12 months (n = 27). Patients were treated with 6 fractions of 1 Gy, two times a week, with a linear accelerator. At the end of therapy, about 70 % of patients reported a response (partial remission or complete remission), 3 months later about 60 %, and 1 year after treatment 70 %...
August 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Rajendra Annappa, Prem Kotian, Janardhana Aithala P, Srikanth Mudiganty
INTRODUCTION: Thumb carpometacarpal dislocation is a rare injury with many treatment options described in literature. CASE DESCRIPTION: A 47-year-old male patient presented to hospital with an isolated dorsal dislocation of the thumb carpometacarpal joint. Closed reduction of the dislocation could be easily done but joint was grossly unstable and redislocated. Repair of ruptured dorsoradial ligament and joint capsule was done with immobilization for 6 weeks. At 2-years follow-up evaluation, the patient was pain free and returned to his previous level of activity...
October 2015: Journal of Orthopaedic Case Reports
Gangyong Huang, Jun Xia, Siqun Wang, Yibing Wei, Jianguo Wu, Feiyan Chen, Jie Chen, Jingsheng Shi
BACKGROUND: Apart from transepicondylar axis, the native femoral sulcus was also reported to be used as a guide for the femoral component position in total knee arthroplasty (TKA). However, it was not shown in patients with severe knee osteoarthritis. This study was conducted to compare the position of trochlear groove in patients with and without osteoarthritis, and to assess whether trochlear groove could be used as a guide for position of femoral component in TKA for severe knee osteoarthritis...
2016: BMC Surgery
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