Trapeziometacarpal Joint Arthroplasty of the Thumb without Osseous Tunnels and Carpal Tunnel Release via a Radial Approach; Technique, and Results

Abstract

Background Numerous surgeries have been described for osteoarthritis of the trapeziometacarpal (TMC) joint. We describe the senior author's experience with his technique of concurrent arthroplasty of the TMC joint, and carpal tunnel release (CTR) via a radial approach.

Methods The study is a case series of patients managed over a 3-year period. We included 86 patients over 40 years of age that had concurrent CTR. We used the paired t-test to compare the preoperative and postoperative grip strength and functional scoring (including the Levine-Katz questionnaire for carpal tunnel syndrome, disabilities of the arm shoulder and hand [DASH] score and QuickDASH9).

Results Mean age at surgery was 62.8 years, and mean follow-up was 13.1 months. Functional outcomes were analyzed in 65 patients. Grip strength returned to the preoperative measurement by 3 months. Analysis of the nine patients followed up for more than 13 months postoperatively showed a significant increase in grip strength at last follow-up. The grip strength in both hands was also similar beyond 13 months. Significant decreases in the functional scores recorded indicated a reduction in disability, symptom severity, and functional impairment.

Conclusions In conclusion, we present the favorable results of this technique of TMC arthroplasty and CTR involving no bone tunnels and short-term immobilization.

Keywords

arthritis - arthroplasty - carpometacarpal joint - thumb - trapeziectomy

Ethical Approval

This study was a retrospective cohort study conducted under approval of the institutional review board of the senior author's institution.

Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation Helsinki Declaration of 1975, as revised in 2008.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Note

Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky, USA.

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