Document Detail


Prospective 1-year follow-up study comparing joint prosthesis with tendon interposition arthroplasty in treatment of trapeziometacarpal osteoarthritis.
MedLine Citation:
PMID:  18929203     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M Ulrich-Vinther; H Puggaard; B Lange
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  33     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2009-02-12     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1369-77     Citation Subset:  IM    
Affiliation:
Division of Hand Surgery, Department of Orthopaedics, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. michael@ulrich-vinther.dk
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MeSH Terms
Descriptor/Qualifier:
Arthroplasty, Replacement / 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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