Measurement of quality of life among patient undergoing arthroplasty of the thumb to treat CMC arthritis

Abstract

ObjectiveTo present the clinical and functional results, including measurement of quality of life, of patients undergoing trapeziometacarpal arthroplasty.MethodThis was a prospective evaluation on 45 patients (53 thumbs) with a diagnosis of idiopathic rhizarthrosis who underwent resection arthroplasty and interposition of an uncemented Ascension® implant, made of pyrocarbon. The clinical and functional results were analyzed through radiography, range of motion (ROM) in degrees (°), visual analog scale (VAS) for pain and the disability of arm, shoulder and hand (DASH) questionnaire for quality of life. In the group analyzed, 38 were women and seven were men, and their mean age was 63.17 years (range: 50–78). Eight patients were treated bilaterally.ResultsAfter 42.08 months of follow-up (range: 8–73), the subjective pain evaluation (VAS) score was 1.37 (range: 1–4). The complete ROM of the thumb increased to 95.75% (range: 75–100%) in relation to the contralateral side. The mean DASH questionnaire score was 9.98 (range: 1–18). The complication rate (negative events) was 11.32%. Five patients presented dislocation of the thumb prosthesis. All of them were reoperated by means of dorsal capsuloplasty using a portion of the retinaculum of the extensors as a graft, and good clinical evolution was achieved in these cases. One patient presented fracturing of the metacarpal and was treated by means of osteosynthesis using Kirschner wires.ConclusionThis method is effective for treating rhizarthrosis, according to the measurements made on the clinical and functional results, even after taking the complication rate into consideration. Moreover, it provides an improvement of quality of life for these patients.

Optimal management of thumb basal joint arthritis: challenges and solutions

“…Park et al demonstrated that LRTI arthroplasty utilizing a segment of the FCR tendon autograft had longer operative times on average and lower preservation of strength at the final follow-up when compared to hematoma distraction arthroplasty and costochondral allograft interposition arthroplasty with ligament reconstruction (Figure 6G). 24 Owing to reports of complications such as complex regional pain syndrome following the traditional trapeziectomy with LRTI arthroplasty, several alternative techniques have been described to provide similar stability and metacarpal height maintained by this procedure 5,20,29–35Trapeziectomy with joint replacement and ligament reconstruction: the use of an implant helps to prevent proximal subsidence of the metacarpal, especially when combined with ligament reconstruction using the TightRope implant to reconstruct the volar oblique ligament connecting the thumb to the index metacarpal (Figure 6H).…”

Targeted Partial Arthroscopic Trapeziectomy and Temporary K-Wire Distraction for Basal Joint Arthritis in Young Patients: A Retrospective Study of 39 Thumbs

“…In our experience, we believe that TMTD causes fewer complications, although a study with a larger cohort is needed to confirm this. In our study, the complication rate was 15%, which is relatively low according to the literature [30][31][32][33][34] with a predominance of nerve irritation that resolved spontaneously, especially at the entry points of the 1-R portal. This rate could be reduced by using the thenar approach 35,36 to the TM joint, which appears to be less risky than the conventional approach.…”

Trapeziometacarpal joint arthritis: A retrospective study of the natural history of symptomatic thumb arthritis

“…Multiple additional studies have investigated surgical treatment options, comparing satisfaction, grip and pinch strength, and risk of complications. [6][7][8][9] Yet even more studies have investigated the progression of generalized arthritis of the hand. [9][10][11][12] These studies however, are population based or based on radiographic evidence of arthritis alone and do not necessarily represent the types of symptomatic patients presenting to hand surgeons.…”