A Promising Thumb Basal Joint Hemiarthroplasty for Treatment of Trapeziometacarpal Osteoarthritis
Clinical Orthopedics and Related Research, 05/29/2012
Pritchett JW et al. – The results are superior to those of other implants and support continued use of this implant. Studies with longer followup are required to confirm these results.Methods
- The authors performed 159 basal joint hemiarthroplasties (138 patients) to treat osteoarthritis of the trapeziometacarpal joint.
- The mean age of the patients was 63 years, 78% were women, and all had Eaton–Littler Stage II or III changes.
- Only the damaged articular surfaces of the metacarpal and trapezium were excised; no tendon grafts or transfers were performed.
- Seven patients (seven thumbs) were lost to followup and seven (nine thumbs) died, leaving 124 patients (143 thumbs) for review.
- Clinical and radiographic assessments were made preoperatively, 12 weeks postoperatively, and annually thereafter.
- Minimum followup was 35 months (mean, 72.1 months; range, 35–120 months).
- At latest followup, pain relief occurred in 135 thumbs, function improved in 138 thumbs, 139 thumbs were excellent or good in overall assessment, and 142 thumbs had good or excellent cosmetic appearance.
- The mean tip pinch improved from 4.9 kg preoperatively to 6.44 kg postoperatively.
- Mean postoperative Buck–Gramcko score was 49 (excellent); overall Kaplan–Meier analysis with revision as the end point showed 94% implant survivorship at a mean followup of 72.1 months.