| Prospective 1-year follow-up study comparing joint prosthesis with tendon interposition arthroplasty in treatment of trapeziometacarpal osteoarthritis. | |
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MedLine Citation:
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PMID: 18929203 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Osteoarthritis of the thumb basal joint is a common and disabling condition. This clinical follow-up study compares the efficacy of total basal joint replacement surgery with that of tendon interposition arthroplasty. METHODS: Ninety-eight patients (mean age, 60 years +/- 1) with severe trapeziometacarpal joint osteoarthritis (Eaton-Littler stage 2.4 +/- 0.1) were included in this prospective follow-up study. Based on written and verbal information, the patients could choose either a cementless, unconstrained, hydroxyapatite-coated trapeziometacarpal joint prosthesis or abductor pollicis longus tendon interposition arthroplasty. Clinical outcome parameters were determined preoperatively and at 3, 6, and 12 months postoperatively. Furthermore, osteo-integration and osteo-fixation of the implants were radiologically analyzed after 12 months. RESULTS: Joint replacement surgery resulted in faster and better pain relief, stronger grip functions, improved range of motion, and faster convalescence than did tendon interposition arthroplasty. After 12 months, patients with joint prostheses had regained the same strength and range of motion as in the asymptomatic contralateral thumb. After 12 months, osteolysis had developed in the vicinity of 2 cups, but there were no signs of implant loosening. The prosthesis surgery was not associated with more complications than occurred with tendon interposition arthroplasty. CONCLUSIONS: This study demonstrates that patients with joint prostheses achieve faster convalescence with better patient comfort and improved strength and range of motion without any increased risk of complications than do patients treated with tendon interposition arthroplasty at 1-year follow up. However, a randomized clinical trial with long-term follow-up is required. |
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Authors:
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M Ulrich-Vinther; H Puggaard; B Lange |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of hand surgery Volume: 33 ISSN: 1531-6564 ISO Abbreviation: J Hand Surg Am Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-20 Completed Date: 2009-02-12 Revised Date: 2009-06-08 |
Medline Journal Info:
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Nlm Unique ID: 7609631 Medline TA: J Hand Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 1369-77 Citation Subset: IM |
Affiliation:
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Division of Hand Surgery, Department of Orthopaedics, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. michael@ulrich-vinther.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arthroplasty, Replacement
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adverse effects,
methods* Carpometacarpal Joints / radiography, surgery* Female Follow-Up Studies Humans Joint Prosthesis* Male Middle Aged Osteoarthritis / radiography, surgery* Pain Measurement Pain, Postoperative / physiopathology Probability Prospective Studies Range of Motion, Articular / physiology Recovery of Function Risk Assessment Severity of Illness Index Statistics, Nonparametric Tendon Transfer / methods* Time Factors Trapezium Bone / physiopathology, surgery Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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