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thumb basal joint arthritis

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
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
Aparajit Naram, Keith Lyons, Douglas M Rothkopf, Edward R Calkins, Thomas Breen, Marci Jones, John V Shufflebarger
BACKGROUND: In the treatment of basal joint arthritis of the thumb, recent studies suggest equivalent outcomes with regard to long-term pain, mobility, and strength, in patients undergoing either trapeziectomy alone or trapeziectomy with ligament reconstruction and tendon interposition (LRTI). The goal of this study was to investigate risk factors for complications in carpometacarpal (CMC) arthroplasty. METHODS: We conducted a retrospective chart review of 5 surgeons at a single institution performing CMC arthroplasties from November 2006 to November 2012...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Jean-David Werthel, Thierry Dubert
UNLABELLED: Recent studies seem to show that ligament reconstruction with tendon interposition (LRTI) does not provide any benefit over trapezium excision alone; however dorsal subluxation was not measured in these studies. We believe it is logical to perform ligamentoplasty in order to obtain long-term stability and therefore treat dorsal subluxation. Our aim is to verify this hypothesis in an observational prospective study of LRTI using the entire flexor carpi radialis (FCR) tendon...
April 2016: Hand Surgery and Rehabilitation
H Lenoir, A Erbland, D Lumens, B Coulet, M Chammas
Total trapeziometacarpal (TMC) joint replacement is increasingly being performed for the treatment of basal joint arthritis. However, complications such as instability or loosening are also frequent with TMC ball-and-socket joint replacement. Management of these complications lacks consensus. The purpose of this study was to report the results of 12 cases of failed TMC joint replacement that were treated by trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. The follow-up consisted of functional (numerical scale, DASH score, satisfaction), physical (range of motion, strength) and radiological (Barron and Eaton ratio measurement) assessments...
February 2016: Hand Surgery and Rehabilitation
Cassie A Ludwig, Nathalie Mobargha, Janet Okogbaa, Elisabet Hagert, Amy L Ladd
Purpose The population of mechanoreceptors in patients with osteoarthritis (OA) lacks detailed characterization. In this study, we examined the distribution and type of mechanoreceptors of two principal ligaments in surgical subjects with OA of the first carpometacarpal joint (CMC1). Methods We harvested two ligaments from the CMC1 of eleven subjects undergoing complete trapeziectomy and suspension arthroplasty: the anterior oblique (AOL) and dorsal radial ligament (DRL). Ligaments were divided into proximal and distal portions, paraffin-sectioned, and analyzed using immunoflourescent triple staining microscopy...
November 2015: Journal of Wrist Surgery
Thomas Waitzenegger, Caroline Leclercq, Emmanuel Masmejean, Hubert Lenoir, Amir Harir, Bertrand Coulet, Michel Chammas
Background Combined thumb basal and wrist joint arthritis (excluding scaphotrapeziotrapezoid arthritis) is rare considering the frequency of arthritis of either joint alone. Combined surgical treatment has never been described in the literature. Furthermore, the scaphoidectomy common to all interventions for Watson stage 2 or 3 wrist arthritis theoretically makes it impossible to perform a trapeziectomy for thumb basal joint arthritis. Question/Purpose The aim of this study was to present and analyze the results of two types of surgical treatment when both wrist and thumb arthritis was present...
November 2015: Journal of Wrist Surgery
Stefan Bohr, Hans Oliver Rennekampff, Norbert Pallua
We report a novel, minimal invasive technique for the treatment of symptomatic arthritis of the carpometacarpal (CMC) joint of the thumb, here termed Cell-Enriched Liposaspirate Arthroplasty (CELA). For CELA, autologous fat tissue was harvested using standard liposuction technique followed by an extra-corporal cellular enrichment step. Finally, 1 ml of cell-enriched lipoaspirate was injected into the CMC-joint. Following CELA, the treated patient became pain free within five weeks with a follow-up of 12 months...
October 2015: Hand Surgery
Kevin Lutsky, Asif Ilyas, Nayoung Kim, Pedro Beredjiklian
BACKGROUND: There is a well-documented association between carpal tunnel syndrome (CTS) and thumb carpometacarpal (CMC) arthritis, and these conditions commonly coexist. We have observed that patients who have previously undergone thumb basal joint arthroplasty (BJA) seem rarely to present subsequently with CTS. Our hypothesis is that BJA decreases the pressure within the carpal tunnel. METHODS: Twenty-eight patients (6 with coexistent CTS) undergoing BJA were enrolled in the study...
September 2015: Hand: Official Journal of the American Association for Hand Surgery
Mustafa Javed, Tarek Nazar, Andrew M Collier
BACKGROUND: Various surgical options used in the treatment of osteoarthritis of the basal joint of the thumb that are refractory to non-surgical management. This study was conducted to provide short term functional outcomes using the mentioned technique in treating basal joint arthritis of the thumb. METHODS: We treated basal joint arthritis of the thumb by trapeziumectomy and volar oblique ligament reconstruction using flexor carpi radialis tendon and "suspension" interposition arthroplasty using the entire tendon split along its length and tied as a double knot at the base of the thumb metacarpal...
January 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Tyson K Cobb, Anna L Walden, Ying Cao
PURPOSE: To report results on 144 cases following arthroscopic resection arthroplasty (ARA) with or without interposition for basal joint arthritis. METHODS: Cases undergoing ARA for thumb carpometacarpal osteoarthritis between 2004 and 2011 were prospectively enrolled (n = 178). Data were collected before surgery and after surgery at 1, 3, 6, and 12 months and annually thereafter. Patients were excluded for less than 1-year follow-up or concomitant procedures that interfered with evaluation of the variable of interest (interposition)...
September 2015: Journal of Hand Surgery
Richard H Gelberman, Sean Boone, Daniel A Osei, Steven Cherney, Ryan P Calfee
PURPOSE: To determine the diagnostic performance (ie, sensitivity, specificity, interrater reliability) of the thumb metacarpal adduction and extension tests against traditional examination maneuvers for trapeziometacarpal (TMC) arthritis. METHODS: This cross-sectional study recruited 129 patients from 2 outpatient offices at a tertiary institution. All patients had radiographic wrist examinations and completed a standardized physical examination consisting of the thumb adduction and extension tests as well as standard examination maneuvers for radial wrist and thumb pain...
July 2015: Journal of Hand Surgery
A Semere, N Vuillerme, D Corcella, A Forli, F Moutet
The Roseland(®) hydroxyapatite-coated prosthesis is a total trapeziometacarpal joint prosthesis used for the surgical treatment of thumb basal joint arthritis. The aim of this retrospective study was to evaluate its long-term outcomes. Fifty-one patients (64 thumbs) underwent trapeziometacarpal joint replacement with this prosthesis. The mean follow-up was 12.5 years. Survival rate of the prosthesis was 91%. There was either no pain or only occasional pain in 91% of cases. The mean QuickDASH score was 27.6...
April 2015: Chirurgie de la Main
Richard A Bernstein
Osteoarthritis of the hand continues to be a problem in an aging population and affects the proximal and distal interphalangeal, metacarpophalangeal, and carpometacarpal joints in the hands. Heberden nodes develop in the distal interphalangeal joints and typically present as a deformed and enlarged joint and can cause pain. Surgery rarely is necessary because functional difficulties are uncommon; however, there may be problems if the metacarpophalangeal and proximal interphalangeal joints are involved because cartilage destruction generates pain and causes weakness and motion loss...
2015: Instructional Course Lectures
Gilles Berrut
Osteoarthritis of the base of the thumb is a common and painful condition, mostly observed in post menopausal women. This paper proposes a critical review of the recent papers in the point of view of geriatric medicine. The basal joint of the thumb is formed by the trapeziometacarpal joint and the carpometacarpal joint of the thumb. The trapeziometacarpal joint is a saddle joint with a wide mobility. The trapezium is most important bone which authorizes movement of rotation towards every finger of the hand...
December 2014: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
J Pech, D Veigl, R Hromádka, J Dobiáš, T Zatrapa
PURPOSE OF THE STUDY: Arthrodesis of the trapeziometacarpal joint is the method of choice in the treatment of degenerative arthritis of this joint. This procedure was indicated most frequently in middle-age patients doing hard manual labor. Methods for achieving a solid fusion of the trapeziometacarpal joint are known and often reported in the literature. Frequently, they are associated with some failure rate, particularly as concerns bone union. Our study presents a simple and effective method verified in cadaver specimens and then currently used at our department...
2014: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Rabah Qadir, Scott F M Duncan, Anthony A Smith, Marianne V Merritt, Cynthia C Ivy, Kousuke Iba
PURPOSE: To document the long-term results of our volar metacarpophalangeal (MCP) joint capsulodesis technique that is completed concomitantly with basal joint arthroplasty and involves a suture anchor placement, short-term pinning, and a rigid hand therapy protocol. METHODS: We conducted a retrospective chart review to examine results over a 30-month period of our volar capsulodesis technique. Follow-up results were recorded 26 to 48 months after surgery. The treatment regimen included suture anchors, joint pinning for 6 weeks, and a strict hand therapy protocol...
October 2014: Journal of Hand Surgery
Dima Raskolnikov, Neil J White, Eric Swart, Ioannis C Zouzias, Melvin P Rosenwasser
Basal joint arthritis leads to thumb metacarpophalangeal (MCP) hyperextension that may prevent physiologic pinch. Various techniques have been used to address this hyperextension, but most are technically challenging, time-consuming, and not supported by long-term follow-up results. Furthermore, few groups have reported subjective, patient-based outcomes after such procedures. In a retrospective study, we evaluated a cohort of 14 patients who underwent a novel technique of thumb MCP capsulodesis in conjunction with basal joint arthroplasty...
August 2014: American Journal of Orthopedics
Guus M Vermeulen, Kim R Spekreijse, Harm Slijper, Reinier Feitz, Steven E R Hovius, Ruud W Selles
PURPOSE: To compare the results for treatment of basal thumb osteoarthritis with and without the use of a bone tunnel at the base of the first metacarpal. METHODS: Women aged 40 years or older with stage IV osteoarthritis were randomized to 1 of 2 treatments. Patients were evaluated preoperatively and postoperatively at 3 and 12 months by assessing pain, outcome function measures, range of motion, strength, time to return to work or activities, satisfaction with the results, and complication rate...
September 2014: Journal of Hand Surgery
Moheb S Moneim, Nathan T Morrell, Deana M Mercer
INTRODUCTION: Osteoarthritis of the thumb trapeziometacarpal (basal) joint is a very common problem facing the hand and upper extremity surgeon. Many surgical procedures have been described with varied results. We present the surgical technique--partial trapeziectomy with capsular interposition arthroplasty--used by the senior author over the last 10 years. The essential steps of the procedure are: bony resection of the base of the first metacarpal and the distal trapezium; interposition of a proximally based joint capsule flap; and reefing of periosteal flaps elevated from the first metacarpal and including the abductor pollicis longus tendon...
September 2014: Techniques in Hand & Upper Extremity Surgery
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