Arthroscopic interposition in thumb carpometacarpal osteoarthritis: A series of 26 cases

Pereira, Ana Maria Geraldes Rodrigues; Ichihara, Satoshi; Facca, S.; Hendriks, S.; Liverneaux, Philippe

doi:10.1016/j.main.2015.08.005

Cited by 14 publications

(21 citation statements)

References 22 publications

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“…20 Arthroscopy can be supplemented by interposition of different biological or manufactured materials. [4][5][6]17 Poly-L-lactic acid (PLLA) implant is a common synthetic interposition material. Pereira et al 3 provided controversial results by combining PLLA with arthroscopy in their long-term follow-up study.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic Synovectomy Combined with Autologous Fat Grafting in Early Stages of CMC Osteoarthritis of the Thumb

2017

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Minimal invasive treatments such as arthroscopic techniques may be adequate to restore the anatomy and functional integrity of the thumb CMC (carpometacarpal) joint. In this paper, we reported the interposition of autologous fat tissue in combination with arthroscopic synovectomy/debridement for early stage of the thumb CMC joint osteoarthritis. Twelve patients with a mean age of 46 years with early radiological stages of thumb CMC joint osteoarthritis were included. Evaluation of outcome was measured prior and 3, 12, and 24 months after surgery including, Visual Analog Scale (VAS), QuickDASH, grip and pinch strength, range of motion (ROM), and patient satisfaction. Pain at rest (or with load) was reduced from preoperative 4,7 (8,7) to 2 (5,9) at 3 to 6 months; 1,4 (4,3) at 12 months; and 0,75 (2,7) at 2 years after the surgery. Initial preoperative QuickDASH value of 52 points reduced to 33 (17-65) at 6 months, 23 (2-70) at 12 months, and 20 (11-29) at 24 months after the surgery. Grip strength and thumb pinch with respect to the contralateral untreated thumb was reduced in the first 12 months but recovered subsequently. ROM was equal to the contralateral thumb. Three patients suffered from tendinitis and required surgical treatment. One patient indicated prolonged pain symptoms. No infections were noted and no donor-site morbidity or side effects were detected. Arthroscopic synovectomy combined with autologous fat graft is a reliable surgical option for early thumb CMC joint osteoarthritis and that effect continues for more than 24 months.

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Section: Discussionmentioning

confidence: 99%

“…4 Synthetic interposition material has the disadvantage of high costs and possible inflammatory or allergic reactions. 5,6 Herold et al first published autologous fat grafts in the thumb CMC joint. In this study, five patients were treated successfully only by fat graft, which was instilled under X-ray control.…”

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confidence: 99%

Arthroscopic Synovectomy Combined with Autologous Fat Grafting in Early Stages of CMC Osteoarthritis of the Thumb

2017

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“…Of other bioabsorbable interposition implants used in TMC arthroplasty, the Artelon™ spacer (Artimplant, Västra Frölunda, Sweden) consisting of partially degradable polyurethane urea has been documented to cause similar adverse tissue reactions as in our patients at 1 year post-operatively (Richard et al., 2014). The Arex™ implant (Arex, Paris, France) consisting of very slowly degrading pure poly-L-lactide (without a D-isomeric form as in the PLDLA (96/4) implant) has also been associated with adverse tissue reactions (Diaconu et al., 2011; Pereira et al., 2015; Semere et al., 2013). Some of these have occurred at the surprisingly early stage of 3 weeks post-operatively (Diaconu et al., 2011) and with implant removal being done as early as 4 months post-operatively (Semere et al., 2013).…”

Section: Discussionmentioning

confidence: 99%

Bioabsorbable poly-L/D-lactide (96/4) scaffold arthroplasty (RegJoint™) for trapeziometacarpal osteoarthritis: a 3-year follow-up study

Mattila

Ainola

Waris

2017

J Hand Surg Eur Vol

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“…Complete removal of the trapezium probably decreases the mechanical stress on the implant thus decreasing the magnitude of the foreign-body reaction. Regarding biocompatibility, the results of the RegJoint™ implant seem better than those of the similar bioabsorbable Arex implant (Arex, Palaiseau, France) and several nonabsorbable implants that have caused adverse tissue reactions in several studies (Pereira et al., 2015; Semere et al., 2013; Spaans et al., 2014; Willekens et al., 2016).…”

Section: Discussionmentioning

confidence: 95%

Unfavourable early outcomes of total trapeziectomy with RegJoint™ interposition: a report of 38 osteoarthritic hands in 34 patients

Mattila

Haapamäki

Waris

2019

J Hand Surg Eur Vol

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This retrospective study analysed the results of total trapeziectomy with RegJoint™ interposition in 38 osteoarthritic hands in 34 patients. Patients were evaluated preoperatively, at follow-up visits, and at a mean final follow-up of 33 months (range 20–53) with plain radiographs, computed tomography, as well as with subjective and objective evaluations. Pain decreased and subjective outcomes and function improved significantly. Computed tomography 18 months after operation showed osteolysis in 24 cases. Three patients developed wrist pain 12–18 months after operation with MRI findings of a foreign-body reaction in each case. One of these patients was scheduled for revision surgery. Although the clinical results were satisfactory, the risk of foreign-body reaction and osteolysis is noteworthy. We conclude that the use of RegJoint™ should be reconsidered since the implant probably offers no benefit in the treatment of trapeziometacarpal osteoarthritis. Level of evidence: IV

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Arthroscopic interposition in thumb carpometacarpal osteoarthritis: A series of 26 cases

Cited by 14 publications

References 22 publications

Arthroscopic Synovectomy Combined with Autologous Fat Grafting in Early Stages of CMC Osteoarthritis of the Thumb

Arthroscopic Synovectomy Combined with Autologous Fat Grafting in Early Stages of CMC Osteoarthritis of the Thumb

Bioabsorbable poly-L/D-lactide (96/4) scaffold arthroplasty (RegJoint™) for trapeziometacarpal osteoarthritis: a 3-year follow-up study

Unfavourable early outcomes of total trapeziectomy with RegJoint™ interposition: a report of 38 osteoarthritic hands in 34 patients

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