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DOI: 10.1055/s-0042-1744384
Proximal Trapezoidectomy and Scaphotrapezoid Joint Tendon Interposition at the Time of Ligament Reconstruction and Tendon Interposition for Pan Trapezial Osteoarthritis Does Not Increase Proximal Carpal Row Malalignment
Funding The authors received no financial support for the research, authorship, and/or publication of this article. The Brisbane Hand and Upper Limb Research Institute receives institutional support and fellowship support from Newclip Technics, Johnson & Johnson (DePuy Synthes), Exactech, Integra LifeSciences, and LMT Surgical.![](https://www.thieme-connect.de/media/jws/202206/lookinside/thumbnails/10-1055-s-0042-1744384_2100115cra-1.jpg)
Abstract
Background Surgical options for osteoarthritis (OA) of the first carpometacarpal include excision, replacement arthroplasty, and arthrodesis. However, in pan trapezial OA, optimal management of residual scaphotrapezoidal articulation has remained unclear.
Purpose The purpose of this study was to evaluate whether removing the proximal trapezoid from the scaphotrapezoid joint (STJ) and interposing tendon when performing a ligament reconstruction and tendon interposition (LRTI) for pan trapezial arthritis resulted in any clinical or radiographic compromise compared with LRTI alone in isolated carpometacarpal joint arthritis.
Methods In a prospective consecutive cohort, 122 thumbs were selected to generate two matched cohorts and a cross-sectional review was completed at an average of 24 months (range: 5–203 months). Fifty-six thumbs had LRTI alone and 66 thumbs also had resection of the proximal portion of the trapezoid with tendon interposition in the residual gap.
Results The cohorts showed no significant differences in subjective and objective outcome measures and imaging. Excision of the STJ was not associated with poorer clinical outcomes or the development of a dorsal intercalated segment instability deformity.
Conclusions The management of pan trapezial arthritis with LRTI and proximal trapezoid excision and STJ interposition appears satisfactory on short- to medium-term clinical and radiographic follow-up.
Level of Evidence: This is a Level III, consecutive cross-sectional cohort study.
Keywords
LRTI - pantrapezial arthritis - partial trapezoidectomy - thumb carpometacarpal arthritis - arthroplasty - scaphotrapeziotrapezoid jointEthical Approval
Ethical approval was obtained from the Brisbane Private Hospital Low Risk Ethics Committee (Reference LREC/18/BPH/1).
Publikationsverlauf
Eingereicht: 27. September 2021
Angenommen: 04. Februar 2022
Artikel online veröffentlicht:
08. Juni 2022
© 2022. Thieme. All rights reserved.
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References
- 1 Kapoutsis DV, Dardas A, Day CS. Carpometacarpal and scaphotrapeziotrapezoid arthritis: arthroscopy, arthroplasty, and arthrodesis. J Hand Surg Am 2011; 36 (02) 354-366
- 2 Tomaino MM, Vogt M, Weiser R. Scaphotrapezoid arthritis: prevalence in thumbs undergoing trapezium excision arthroplasty and efficacy of proximal trapezoid excision. J Hand Surg Am 1999; 24 (06) 1220-1224
- 3 Andrachuk J, Yang SS. Modified total trapezial and partial trapezoidal excision and ligament reconstruction tendon interposition reduces symptoms in isolated scaphotrapezial-trapezoid arthritis of the wrist. J Hand Surg Eur Vol 2012; 37 (07) 637-641
- 4 Langenhan R, Hohendorff B, Probst A. Trapeziectomy and ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist. J Hand Surg Eur Vol 2014; 39 (08) 833-837
- 5 Tay SC, Moran SL, Shin AY, Linscheid RL. The clinical implications of scaphotrapezium-trapezoidal arthritis with associated carpal instability. J Hand Surg Am 2007; 32 (01) 47-54
- 6 Döring AC, Overbeek CL, Teunis T, Becker SJE, Ring D. A slightly dorsally tilted lunate on MRI can be considered normal. Arch Bone Jt Surg 2016; 4 (04) 348-352
- 7 Ishida O, Tsai TM. Complications and results of scapho-trapezio-trapezoid arthrodesis. Clin Orthop Relat Res 1993; (287) 125-130
- 8 Garcia-Elias M, Lluch AL, Farreres A, Castillo F, Saffar P. Resection of the distal scaphoid for scaphotrapeziotrapezoid osteoarthritis. J Hand Surg [Br] 1999; 24 (04) 448-452
- 9 Hasselbacher K, Steffke M, Kalb K. Is chronic, untreated scapho-trapezoid arthrosis after resection arthroplasty of the carpometacarpal joint clinically relevant? [in German]. Handchir Mikrochir Plast Chir 2001; 33 (06) 418-423
- 10 Rectenwald JP, Green DP, Dobyns JH. Symptomatic carpal collapse after trapeziectomy and partial trapeziodectomy: report of two cases. J Hand Surg Am 2005; 30 (04) 706-710
- 11 Alolabi N, Hooke AW, Kakar S. The biomechanical consequences of trapeziectomy and partial trapezoidectomy in the treatment of carpometacarpal and scaphotrapeziotrapezoid arthritis. J Hand Surg Am 2020; 45 (03) 257.e1-257.e7