Download PDF
J Hand Microsurg 2009; 01(01): 7-11
DOI: 10.1007/s12593-009-0011-x
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Comparative study between trapezium resection and tendon interposition with and without ligamentplasty in the management of carpometacarpal arthrosis of the thumb

Arlindo G. Pardini Jr.
,
Afrânio D. Freitas
,
Antonio B. Chaves
,
Marcel B. Freitas
Subject Editor:
Further Information

Publication History

11 December 2008

03 March 2009

Publication Date:
02 September 2016 (online)

  PDF Download  Permissions and Reprints

Abstract

Purpose

Treating arthrosis in the base of the thumb has been a highly controverted subject. Many surgeries have been described, such as the isolated trapezium resection; resection with interposition with and without ligament plasty; arthrodesis, and arthroplasties. The purpose of this paper is to compare the two techniques which are currently the most used in this treatment.

Methods

A prospective study has been made to compare the surgical results between the trapezium resection with tendon interposition (tenoarthroplasty) – 22 cases – and tenoarthroplasty associated to ligament plasty—24 cases. Objective evaluation was done by measuring opponence, movements of the metacarpophalangeal joint, pinch and grasp strength, radiographic measurement of the distance between the base of first metacarpal and the scaphoid, and measurement of the angle between the first and the second metacarpals. Subjective evaluation was done with a DASH questionnaire, visual analog scale to evaluate pain and patient satisfaction.

Results and conclusion

After application of the criteria described and using Student ‘t’ tests for statistical analysis, the authors concluded that the ligament reconstruction has no advantage over the simple resection and tendon interposition in carpometacarpal arthrosis of the thumb.

Keywords

Osteoarthritis - Trapezium bone surgery - Thumb pathology - Musculoskeletal diseases surgery - Arthroplasty methods - Comparative studies
 

  • References

  • 1 Gervis WH. Excision of the trapezium for osteoarthritis of the trapezium-metacarpal joint. J Bone Joint Surg Br 1949; 31: 537-539
    PubMedSearch in Google Scholar
  • 2 Davis TRC, Brady O, Dias JJ. Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: a study on the benefit of ligament reconstruction or tendon interposition. J Hand Surg Am 2004; 29: 1069-1077
    CrossrefPubMedSearch in Google Scholar
  • 3 De Smet L, Sioen W, Spaepen D, Van Rausbeeck. Trapeziectomy with or without tendon interposition ligament reconstruction. Hand Surg 2004; 9: 5-9
    CrossrefPubMedSearch in Google Scholar
  • 4 Varley GW, Calvey J, Hunter JB, Barton NJ, Davis TR. Excision of the trapezium for osteoarthritis of the base of the thumb. J Bone Joint Surg Br 1994; 76: 964-968
    PubMedSearch in Google Scholar
  • 5 Amadio PC. ‘Letters to the Editor’: a comparison of fusion, trapeziectomy and silastic replacement for the treatment of osteoarthritis of the trapezio metacarpal joint. J Hand Surg Br. 2005; 30: 331-332
    CrossrefPubMedSearch in Google Scholar
  • 6 Gibbons CE, Gosal HS, Chouldri AH, Mangnussen PA. Trapeziectomy for basal thumb joint osteoarthritis: 3 to 19 year follow-up. Int Orthop 1999; 23: 216-218
    CrossrefPubMedSearch in Google Scholar
  • 7 Iyer KM. The results of excision of the trapezium. Hand 1981; 13: 246-250
    CrossrefPubMedSearch in Google Scholar
  • 8 Eaton RG, Lane LB, Littler JW, Keyser JJ. Ligament reconstruction for the painful thumb carpometacarpal joint: a long-term assessment. J Hand Surg Am 1984; 9: 692-699
    CrossrefPubMedSearch in Google Scholar
  • 9 Friedman DM, Eaton RG, Glickel SZ. Long-term results of volar ligament reconstruction for symptomatic basal joint laxity. J Hand Surg Am 2000; 25: 297-304
    CrossrefPubMedSearch in Google Scholar
  • 10 Rayan GM, Young BT. Ligament reconstruction arthroplasty for trapeziometacarpal arthrosis. J Hand Surg Am 1997; 22: 1067-1076
    CrossrefPubMedSearch in Google Scholar
  • 11 Illarramendi AA, Boretto JG, Gallucci GL, De Carli P. Trapeziectomy and intermetacarpal ligament reconstruction with the trapeziometacarpal joint: surgical technique and long term results. J Hand Surg Am 2006; 31: 1315-1321
    CrossrefPubMedSearch in Google Scholar
  • 12 Thompson JS. Suspensionplasty. J Orthop Surg Technol 1989; 4: 1-13
    PubMedSearch in Google Scholar
  • 13 Eaton RG, Glickel SZ, Littler JW. Tendon interposition arthroplasty for degenerative arthritis of the trapezio-metacarpal joint of the thumb. J Hand Surg Am 1985; 10: 645-654
    CrossrefPubMedSearch in Google Scholar
  • 14 Froimson AI. Tendon interposition arthroplasty of carpometacarpal joint of the thumb. Hand Clin 1987; 3: 489-505
    CrossrefPubMedSearch in Google Scholar
  • 15 Weilby A. Tendon interposition arthroplasty of the first carpometacarpal joint. J Hand Surg Br 1988; 13: 421-425
    CrossrefPubMedSearch in Google Scholar
  • 16 Froimson AI. Tendon arthroplasty of the trape-ziometacarpal joint. Clin Orthop 1970; 70: 191-199
    PubMedSearch in Google Scholar
  • 17 Burton RI, Pellegrini Jr VD. Surgical management of basal joint arthritis of the thumb. Par II: ligament reconstruction with tendon interposition arthroplasty. J Hand Surg Am 1986; 11: 324-332
    CrossrefPubMedSearch in Google Scholar
  • 18 Tomaino MM. Ligament reconstruction tendon interposition arthroplasty for basal joint arthritis. Rationale, current technique and clinical outcome. Hand Clin 2001; 17: 207-221
    PubMedSearch in Google Scholar
  • 19 Tomaino MM, Pellegrini Jr VD, Burton RI. Arthroplasty of the basal joint of the thumb. Long term follow-up after ligament reconstruction. J Bone Joint Surg Am 1995; 77: 346-355
    Search in Google Scholar
  • 20 Field J, Buchanan D. To suspend or not suspend: a randomized single blind trial of simple trapeziectomy versus trapeziectomy and flexor carpi radialis suspension. J Hand Surg 2007; 46: 462-466
    PubMedSearch in Google Scholar
  • 21 Belcher HJ, Michael JE. A comparison of trapeziec-tomy with and without ligament reconstruction and tendon interposition. J Hand Surg Br 2000; 25: 350-356
    CrossrefPubMedSearch in Google Scholar
  • 22 Pardini Jr AG, Lazaroni AP, Tavares KE. Compression arthrodesis of the carpometacarpal joint of the thumb. Hand 1982; 14: 291-294
    CrossrefPubMedSearch in Google Scholar
  • 23 Pardini Jr AG, Vilela EA. Osteoartrite carpo-metacarpica do polegar. Estudo comparativo entre artroplastia de interposi ção tendinosa, artrodese e ligamentoplastia. Rev Bras Ortop 1995; 30: 219-226
    PubMedSearch in Google Scholar
  • 24 Mureau MA, Rademaker RP, Verhaar JA, Hovius SE. Tendon interposition arthroplasty versus arthrodesis for the treatment of trapeziometacarpal arthritis: a retrospective comparative follow-up study. J Hand Surg Am 2001; 26: 869-876
    CrossrefPubMedSearch in Google Scholar
  • 25 Hartigan BJ, Stern PJ, Kiefhaber TR. Thumb carpometacarpal osteoarthritis: arthrodesis compared with ligament reconstruction and tendon interposition. J Bone Joint Am 2001; 83: 1470-1478
    PubMedSearch in Google Scholar
  • 26 Swanson AB. Disabling arthritis at the base of the thumb: treatment by resection of the trapezium and flexible (silicone) implant arthroplasty. J Bone Joint Am 1972; 54: 456-471
    PubMedSearch in Google Scholar
  • 27 Albertoni WM, Leite VM, Faloppa F, Galbiatti JÁ. Prótese total de De La Caffinière no tratamento da ri-zartrose do polegar. Rev Bras Ortop 1992; 27: 581-586
    PubMedSearch in Google Scholar
  • 28 Badia A, Sambandan SN. Total joint arthroplasty in the treatment of advanced stages of thumb carpometacarpal joint osteoarthritis. J Hand Surg Am 2006; 31: 1605-1614
    PubMedSearch in Google Scholar
  • 29 Caffinière JY, Aucouturier P. Trapeziometacarpal arthroplasty by total prosthesis. Hand 1979; 11 ((1)) 41-46
    PubMedSearch in Google Scholar
  • 30 Eaton RG, Glieckel SZ. Trapeziometacarpoal osteoarthritis staging as a rationale for treatment. Hand Clin 1983; 3: 455-469
    PubMedSearch in Google Scholar
  • 31 Jester A, Harth A, Wind G, Germann G, Sauerbier M. Disabilities of the arm, shoulder and hand (DASH) questionnaire: determining functional activity profiles in patients with upper extremity disorders. J Hand Surg Br 2005; 30: 23-28
    CrossrefPubMedSearch in Google Scholar
  • 32 Conolly WB, Rath S. Revision procedures for complications of surgery for osteoarthritis of the carpometacarpal joint of the thumb. J Hand Surg Br 1993; 18: 533-539
    CrossrefPubMedSearch in Google Scholar