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thumb basal joint arthritis

Joseph J Schreiber, Thomas J McQuillan, Eni Halilaj, Joseph J Crisco, Arnold-Peter Weiss, Tarpit Patel, Deborah Kenney, Amy L Ladd
PURPOSE: Thumb carpometacarpal (CMC) osteoarthritis (OA) represents a major source of functional morbidity. The effects of early CMC OA on loading and use patterns potentially lead to changes in local bone density and microarchitecture. Hounsfield units (HU), a quantitative attenuation coefficient obtained from computed tomography (CT) scans, have been shown to be a reliable marker of bone density. We hypothesized that early CMC OA is associated with lower local bone density about the CMC joint as assessed by HU...
October 10, 2017: Journal of Hand Surgery
Daniel Mckee, Donald Lalonde
Supplemental Digital Content is available in the text.
August 2017: Plastic and Reconstructive Surgery. Global Open
Sheriff D Akinleye, Garret Garofolo-Gonzalez, Michael Montuori, Maya Deza Culbertson, Jennifer Hashem, David Marc Edelstein
BACKGROUND: The American Medical Association (AMA) and National Institutes of Health (NIH) recommend that patient education materials be written at no higher than a sixth-grade reading level. METHODS: We examined 100 online educational materials for the 10 hand conditions most commonly treated by hand surgeons, as reported by the American Society for Surgery of the Hand. The listed conditions were carpal tunnel syndrome, basal joint arthritis of the thumb, de Quervain syndrome, Dupuytren's contracture, ganglion cysts, hand fractures, trigger finger, extensor tendon injuries, flexor tendon injuries, and mallet finger...
August 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
Peter C Noback, Joseph M Lombardi, Mani Seetharaman, Donald H Lee, Robert J Strauch, Melvin P Rosenwasser
Background The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is the most commonly used instrument to assess outcomes of basal joint arthritis (BJA). However, the DASH is subject to influence by the entire upper extremity. Purpose This study aims to develop and validate a disease-specific questionnaire for BJA that would be more sensitive to changes in thumb function and pain, and correlate better with objective and subjective metrics. Patients and Methods The thumb disability examination (TDX) was developed and 80 patients presenting with BJA at one of the two hospital-based hand clinics were enrolled in the validation study...
May 2017: Journal of Wrist Surgery
Richard H J Baker, Jaber Al-Shukri, Tim R C Davis
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Assess the patient's history, clinical examination, and radiographic findings to diagnose and stage basilar joint arthritis. 2. Recall the cause and epidemiology of the condition. 3. Formulate a management plan including nonoperative management, and evaluate the candidacy for surgical treatment. 4. Understand the rationale for the various surgical options available (including rehabilitation), their potential complications, and the evidence related to outcomes...
January 2017: Plastic and Reconstructive Surgery
Chirag Kapoor, Ankur Kansagra, Maulik Jhaveri, Aditya Merh, Paresh Golwala
Thumb pain secondary to arthritis at the basal joint of the thumb is a common condition, especially in women, and can be quite disabling. An accurate diagnosis can be readily made from the history and examination. Reconstructive procedures for each stage of the disease are aimed at relieving pain and restoring thumb motion and strength. There are a number of methods available to treat this condition both conservatively and surgically with variable success rates. We present a case of a middle-aged female with first carpo-metacarpal (CMC) joint arthritis in whom we have tried a new technique in which the trapezium is excised, crushed, put in a sponge covering and then inserted back in the void created after excision...
November 3, 2016: Curēus
G Pomares, D Delgrande, F Dap, G Dautel
HYPOTHESIS: The aim of this article is to analyze clinical and radiological outcomes of trapeziectomy performed for basal thumb arthritis after a minimum follow-up of 10 years to gain further insight from shorter and medium-term studies reporting satisfactory evolution. METHODS: We reviewed 67 trapeziectomies, operated on by the same senior surgeon after a minimum follow-up of 10 years. The sample included 16 cases of suspensionplasty and 51 interpositions. Clinical outcome evaluated strength, pain, joint amplitude, Kapandji opposition score, Disabilities of the Arm, Shoulder and Hand score, complications and revision surgery...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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
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