Arthroscopic ligamentoplasty for osteoarthritis of the thumb carpometacarpal joints: Clinical and radiological outcomes with a minimum 2-year follow-up

Tsujii, Masaya; Iida, R.; Oshima, Yu; Odake, Kazuya; Satonaka, Haruhiko; Kokubu, Naoki; Sudo, Akihiro

doi:10.1016/j.jos.2019.03.012

Cited by 6 publications

(21 citation statements)

References 17 publications

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“…Similar to the interposition procedures, the case series on trapeziectomy and suspensionplasty have also shown promising improvements in pain and function. 28,29,43,49,51 Unfortunately, due to the low quality of prospective comparison studies, it is not possible to determine which arthroscopic technique is superior to the others in producing better pain and functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…38,39,[43][44][45][47][48][49]51,60,64 Oppositional pinch strength was measured in 10 studies, both preoperatively 32,42 43,45,47-49,51,52,60 and postoperatively. 32,39,43,45,[47][48][49]51,52,60 Appositional pinch strength was recorded in four studies preoperatively 38,44,45,51 and five studies postoperatively. 38,39,44,45,51 In the combined analysis of all included studies, overall preoperative and postoperative means were significantly different for resting pain scores, active pain scores, and DASH scores (►Table 3).…”

Section: Clinical Outcomes Of All Studiesmentioning

confidence: 99%

“…32,39,43,45,[47][48][49]51,52,60 Appositional pinch strength was recorded in four studies preoperatively 38,44,45,51 and five studies postoperatively. 38,39,44,45,51 In the combined analysis of all included studies, overall preoperative and postoperative means were significantly different for resting pain scores, active pain scores, and DASH scores (►Table 3). There were significant improvements from preoperative to postoperative weighted averages for the pain at rest, pain with activity, and DASH scores of 5.36, 5.89, and 19.61 points, respectively.…”

Section: Clinical Outcomes Of All Studiesmentioning

confidence: 99%

“…They potentially overcome some of the aforementioned issues by avoiding a capsulotomy and more extensive soft tissue disruption while instead preserving the native anatomy to provide stability and potentially an expedited recovery. 32,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] Arthroscopy of the small joints of the wrist and hand was first described in the late 1970s. 53 However, its popularity started to rise markedly in 1996 after Menon published the first article on the use of arthroscopy for the first CMC joint.…”

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confidence: 99%

“…Since then, multiple arthroscopic techniques have been described and studied in small studies consisting of mostly nonrandomized cohort studies. 32,38,39,[41][42][43][44][45][46][47][48][49][50][51] To date, there has been a lack of large, prospective controlled trials comparing these methods. Additionally, efforts to compare these smaller studies have failed to encompass all published papers, included poorly designed studies, or reported results from a broad range of techniques without focusing on arthroscopy alone.…”

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confidence: 99%

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Treatment of First Carpometacarpal Osteoarthritis with Arthroscopy: A Systematic Review

et al. 2022

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Background First carpometacarpal (CMC) osteoarthritis or trapeziometacarpal osteoarthritis is a common debilitating hand condition. No one surgical technique has demonstrated superiority in managing this disease. Purpose This study performed a systematic review of arthroscopic techniques for treating first CMC arthritis to assess the effectiveness of different arthroscopic techniques. Methods Grip strength, pinch strength, visual analog scale, the Disability of Arm, Shoulder, and Hand (DASH) score, range of motion (ROM), and complications were recorded. Two subgroup analyses were performed, comparing outcomes of (1) trapeziectomy of any type versus debridement alone and (2) trapeziectomy alone versus interposition versus suspension techniques. Results Preoperative and postoperative scores significantly improved for DASH scores and pain at rest and with activity with variable improvements in ROM. Complications occurred in 13% of cases in publications that reported complications. When comparing studies that utilized techniques with any type of trapeziectomy to debridement alone, only the trapeziectomy subgroup showed significant improvements in pain. When comparing trapeziectomy alone to interposition and suspension techniques, mean DASH scores and pain levels significantly improved in interposition and suspension subgroups. Conclusions The existing literature describes a predominantly female population with Eaton-Littler stage II and III disease. In the subgroup analysis, arthroscopic techniques involving a trapeziectomy seem to be more effective at lowering pain scores compared to techniques involving debridement alone. Likewise, interposition and suspension techniques may show improved outcomes compared to techniques involving trapeziectomy alone. Level of evidence This is a Level III study.

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