Arthroscopic Partial Trapeziectomy With Soft Tissue Interposition for Symptomatic Trapeziometacarpal Arthritis: 6-Month and 5-Year Minimum Follow-Up

作者：Logli Anthony L; Twu Jonathan; Bear Brian J^*; Lindquist Jonathan R; Schoenfeldt Theodore L; Korcek Kenneth J

来源：Journal of Hand Surgery-American Volume, 2018, 43(4): UNSP 384.e1-e7.

DOI：10.1016/j.jhsa.2017.10.016

• Arthroscopic resection arthroplasty
• basal joint arthritis
• carpometacarpal osteoarthritis
• interposition

Purpose To determine if arthroscopic partial trapeziectomy (APT) and soft tissue interposition arthroplasty is an effective treatment for symptomatic trapeziometacarpal arthritis.
Methods We retrospectively evaluated 30 consecutive patients with symptomatic isolated trapeziometacarpal arthritis, Eaton-Littler stages II and III. Treatment consisted of an APT with soft tissue interposition utilizing an acellular dermalmatrix as the interpositionmaterial. At aminimum of 6 months and 5 years after surgery, Numeric Pain Rating Scale (NPRS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), grip strength, oppositional and appositional pinch strengths, arthroplasty space, and thumb range of motion (ROM) were evaluated.
Results At 6-month minimum follow-up, 30 of 30 patients reported a significant reduction in pain; preoperative NPRS averaged 8.2 and decreased to 1.3. Average QuickDASH score was 17.5. Twenty-nine of 30 thumbs could adduct fully in the plane of the palm. Twenty-four patients were available for 5-year minimum follow-up. Average QuickDASH score measured 8.9, whereas pain (mean NPRS, 0.8), grip, and pinch strengths were not significantly different from the 6-month assessment. There was a small reduction in arthroplasty space at 5-year follow-up that did not affect clinical outcome measures. Thumb ROM did not change between the 6-month and the 5-year follow-up. Complications were rare.
Conclusions An APT with interposition arthroplasty utilizing an acellular dermal matrix as the interposition material is a safe and reliable procedure with satisfactory outcomes at short-and long-term follow-up. Pain, strength, QuickDASH, and ROM do not significantly change between the 6-month and the 5-year follow-up.

• 出版日期2018-4