Long-Term Outcomes After Partial Trapeziectomy With Capsular Interposition Arthroplasty For Treating Osteoarthritis Of The Thumb Basal Joint
Moheb S Moneim, MD1; Deana Mercer, MD2; Christina Salas, PhD1; Andrea B Lese, MD3; Norfleet B Thompson, MD4
1University of New Mexico, Albuquerque, NM; 2Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, NM; 3West Virginia University, Morgantown, WV; 4Clinic, Memphis, TN
Abstract Introduction: To describe long-term outcomes of partial trapeziectomy with capsular interposition (PTCI) arthroplasty for treating patients with osteoarthritis (OA) of the basal joint of the thumb. Materials & Methods: 27 patients (20 women, 7 men; 32 thumbs) with a mean age of 61 years (range, 47-74 years) agreed to return for follow-up and were included in the study. Mean postoperative follow-up was 64.3 months (range, 28-112 months). Evaluation included tests for grip strength and pinch strength; range of motion of the metacarpophalangeal (MCP) joint; measurement of the first web space; completion of Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire; visual analogue scale (VAS) measurements; and radiographic examination of the hand. The Student test was used to determine statistical significance (P < 0.05) of pre- and postoperative values between the groups. Results: Postoperative values for grip strength were significantly increased from preoperative values. No significant loss of pinch strength was noted; excessive hyperextension of the MCP joint did not occur; and the first web space was maintained. The mean DASH and VAS scores were 5.06 (range, 0-26.5) and 0.3, respectively. Use of PTCI resulted in minimal loss in thumb height (7%) and significantly reduced thumb metacarpal subluxation (13%). There were no reported complications. Conclusions: The low DASH and VAS scores compare well with other studies and indicate a good functional outcomes. In treating thumb, basal joint OA, use of PTCI may result in improved thumb stability and grip strength, minimal subsidence of the thumb metacarpal, and reduced joint subluxation. Type of study/level of evidence: Case series.
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