Trapeziectomy

Osteoarthritis in the thumb carpometacarpal joint causes pain, swelling, deformity, instability, loss of motion, and power, which seriously impairs overall hand function. Surgery is indicated if conservative treatment fails to relieve the pain. Trapeziectomy is the most popular surgical treatment choice and yields good range of motion and relieves pain with the fewest complications. Arthroscopic trapeziectomy is gaining popularity. In general, the arthroscopic procedure is performed under continuous traction with a traction tower...

BACKGROUND: Patients undergoing plastic surgery have traditionally been instructed to avoid anticoagulants and antiplatelets during the perioperative period to avoid bleeding that could lead to painful hematomas, skin necrosis, unplanned procedures, and blood transfusions. Many veterans are currently prescribed anticoagulants for prevention of life- and limb-threatening embolic and thrombotic events. In early 2015, the plastic surgery service began to instruct patients undergoing elective hand surgery to stay on their prescription anticoagulant perioperatively...

Pain after trapeziectomy is a vexing problem, most commonly due to scaphometacarpal impingement. A number of treatment strategies have been described and are examined in this systematic review. In total, 27 studies describing revision surgery for unsatisfactory results after trapeziectomy were included. Results after soft tissue or synthetic suspensionplasties, arthrodesis procedures, implant arthroplasty and costochondral autografting were included. Most studies were heterogeneous in terms of patient selection and procedure performed, and the level of evidence and methodological quality were uniformly low...

BACKGROUND: Trapeziometacarpal (TMC) osteoarthritis (OA) is a common cause of pain and weakness during thumb pinch leading to disability. There is no consensus about the best surgical treatment in unresponsive cases. The treatment is associated with costs and the recovery may take up to 1 year after surgery depending on the procedure. No randomized controlled trials have been conducted comparing ball and socket TMC prosthesis to trapeziectomy with ligament reconstruction. METHODS: A randomized, blinded, parallel-group superiority clinical trial comparing trapeziectomy with abductor pollicis longus (APL) arthroplasty and prosthetic replacement with Maïa® prosthesis...

Trapeziometacarpal joint osteoarthritis (TMJO) affects up to 33% of postmenopausal women, leading to pain, reduced mobility, and grip strength, with initial treatments focusing on non-surgical options like injections, orthoses, and exercises before considering surgery. A major challenge in managing TMJO involves selecting the optimal surgical strategy that is customized to individual clinical conditions. This study aimed to compare the effectiveness of three common surgical interventions for TMJO in relieving pain, including arthroscopic debridement (AD), trapeziectomy (TRAP), and joint replacement (JR)...

Background  Osteoarthritis at the base of the thumb is the most frequent osteoarthritis of the hand. Trapeziectomy in a broad variety of surgical methods have been proposed to achieve pain reduction and improvement of thumb function. A well-known disadvantage is the long recovery time. Arthroplasty of the thumb carpometacarpal joint is a competing new method for this indication with different revision and complication rates reported. Purposes  The aim of this study is to assess whether there are significant differences in outcome during the first 12 months and time return to work after either, implant of a Maïa joint prosthesis, or trapeziectomy with tendon interposition after Weilby...

Genome-wide association study identified common variants within the ALDH1A2 gene as the susceptible loci of hand osteoarthritis (HOA) in UK and Iceland populations. Located in chromosome 15, ALDH1A2 encodes aldehyde dehydrogenase family 1 member A2, which is an enzyme that catalyses the synthesis of retinoic acid from retinaldehyde. Our purposes were to replicate the association of functional variant in ALDH1A2 with the development of HOA in the Chinese population. Variant rs12915901 of ALDH1A2 was genotyped in 872 HOA patients and 1223 healthy controls...

OBJECTIVE: Thumb osteoarthritis is a frequent pathology, mainly affecting the elderly. The surgical treatment initially described and having proved its worth is total trapeziectomy. Since the advent of trapeziometacarpal prostheses, several studies showed the non-inferiority of this technique on clinical criteria, with superiority in bone sparing, although neither technique demonstrated overall superiority. We therefore examined the specific complications of each surgical technique by analyzing their nature and prevalence through a review of the literature to compare them on these new parameters...

BACKGROUND: In patients with symptomatic trapeziometacarpal (TMC) joint arthritis resistant to conservative treatment, surgical treatment can be advised. One of the many surgical treatment options is TMC arthroplasty. The Arpe prosthesis is one example of these TMC arthroplasties. METHODS: This retrospective study evaluated patients who underwent TMC arthroplasty with the Arpe prosthesis after a minimum of 15 years of follow-up. Clinical, radiologic, and qualitative outcomes were assessed for 43 Arpe arthroplasties in 41 patients, of whom 2 had bilateral arthroplasties...

The management of complications after surgery for basal thumb arthritis is sometimes challenging, and there are no clear recommendations on how to evaluate and manage patients with residual symptoms. The aim of the present article was to review the most common complications after surgery for basal thumb arthritis, with an emphasis on resection arthroplasty, joint replacement and joint fusion. In addition, possible management strategies for the different types of complications will be highlighted.

We compared the effects of capsule resection versus capsule suturing in patients treated with a dual-mobility trapeziometacarpal joint prosthesis. We included 131 patients with capsular resection and 57 patients with repair. The mean scores for pain and the brief Michigan Hand Outcomes Questionnaire were similar between the groups preoperatively and at 6 weeks and 1 year postoperatively. Mean key pinch strength was also similar in both groups before surgery and at 1 year, but higher in the capsular resection than in the suture group at 6 weeks...

The aim of this Delphi study was to provide a diagnostic and treatment algorithm for patients with persistent or recurrent symptoms after trapeziometacarpal joint resection arthroplasty. Three Delphi rounds were conducted in which surveys were sent to 182 experienced hand surgeons worldwide. Responses were received from 140 participants. A consensus threshold was set at 67% agreement. Diagnostic tools and treatment approaches for six common revision scenarios achieved consensus. Radiographs are appropriate as primary (97%) and CT scans as secondary (76%) diagnostic tools...

BACKGROUND: The purpose of this study was to compare the cyclic and load to failure characteristics of post-trapeziectomy suspensionplasty with the FiberLock Suspension System (FLSS; Arthrex Inc., Naples, Florida) to flexor carpi radialis ligament reconstruction (FCRLR). We hypothesized that the FLSS will have increased stiffness, yield, and ultimate load compared with FCRLR. METHODS: Ten matched pairs of cadaveric hands were used. One side of each pair was randomly assigned to receive the FCRLR or FLSS and the contralateral side received the other suspensionplasty...

Background  This paper's purpose was to analyze clinical results obtained with trapeziometacarpal arthrodesis and complications comparing different osteosynthesis systems. Methods  Thirty-seven trapeziometacarpal arthrodesis were performed in our center in a 7-year period, with a mean age of 52 years and 34 months of follow-up. The implants were distributed homogenously into three groups, using bone grafts in 12.5% of them. Results  A 75% achieved complete consolidation with a mean postsurgical Visual Analog Scale (VAS) of 2...

Joint replacement arthroplasty for the treatment of thumb osteoarthritis is gaining popularity as recent studies have demonstrated better pinch and grip strength and faster rehabilitation. Our aim was to identify early complications in modern implant designs using a multicenter study. A total of 381 patients who underwent thumb carpometacarpal replacement surgery in six participating hospitals were enrolled. The complications included were fractures, dislocations, infections, tendon and nerve injuries, and complex regional pain syndrome...

INTRODUCTION: The aim of this prospective and randomized study is to analyze and compare the outcomes of two surgical techniques for trapeziometacarpal joint osteoarthritis (Eaton-Littler grade III and IV). MATERIALS AND METHODS: 52 consecutive patients underwent surgical intervention by two different surgical techniques and checked for subjective outcomes (DASH, NPRS), objective outcomes (ROM, opposition test, grinding test, pulp pinch, hand grip) and radiographic outcomes...

INTRODUCTION: Non-dissociative carpal instability (CIND) may lead to severe functional impairment. Destabilisation of the scapho-trapezial-trapezoidal (STT) ligament complex seems to result in a CIND. MATERIALS AND METHODS: In one group with eight cadaver arms, distal scaphoid pole was resected with the adjacent ligaments. In the other eight cadavers, hemitrapeziectomy was performed followed by total trapeziectomy. CT scans were performed in different wrist positions, and the changed positions of the scaphoid, lunate and capitate were measured in comparison to non-operated wrists...

PURPOSE: Trapeziectomy with tendon reconstruction/suspensionplasty (TRS) is the most commonly performed surgical procedure in the United States for treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). Trapeziectomy with suture tape suspensionplasty (STS) has been used recently at the study institution as an alternative surgical treatment option with perceived benefits of earlier return to function and reduced operative time. The purpose of this study was to compare patient outcomes following TRS versus STS for treatment of thumb CMC OA...

» The scaphotrapeziotrapezoid (STT) joint is a common location of degenerative osteoarthritis (OA) in the wrist.» STT OA may occur in isolation or with concomitant thumb carpometacarpal joint (CMCJ) OA or scapholunate advanced collapse (SLAC) and other wrist OA patterns.» Nonoperative management strategies include activity modification, bracing, anti-inflammatory medications, occupational therapy, and injections.» Surgical treatment may be determined by whether the STT OA occurs in isolation or with concomitant thumb CMCJ or SLAC OA and includes STT arthrodesis, distal scaphoid excision with or without interposition or implant arthroplasty, trapeziectomy with proximal trapezoid excision, four-corner fusion in combination with scaphoid/radial column excision, and proximal row carpectomy...

Trapeziometacarpal osteoarthritis (carpometacarpal arthritis / CMC-1 arthritis) is a common cause of chronic thumb pain and may significantly worsen patients' quality of life. The thumb is the most important digit of the hand. A diagnostic-therapeutic algorithm for CMC-1 arthritis should be widely known and based on up-to-date evidence-based medical knowledge. The literature describes many medical and surgical treatment approaches. The methods used vary between hospitals and clinics. They also depend on patients' financial capabilities and many other factors...