De Quervain Tenosynovitis Following Trapeziometacarpal Ball-and-Socket Joint Replacement

Abstract

Osteoarthritis at the base of the thumb can cause severe pain, weakness, and deformity and can result in marked disability. Shear stress forces, due to weakening of the palmar beak ligament, can cause damage to the articular cartilage that can progress to degenerative osteoarthritis. 1 Initially, osteoarthritis of the trapeziometacarpal (TMC) joint should be treated conservatively. Surgery has been suggested in cases of pain that hampers the activities of daily life. In one study, patients treated conservatively had subjectively worse results than patients who underwent surgery. 2 Keywords ► trapeziometacarpal ► ball-and-socket prosthesis ► lengthening ► de Quervain AbstractBackground One of the surgical treatment options for trapeziometacarpal (TMC) joint arthritis is a prosthetic ball-and-socket replacement. One of the complications in the postoperative setting is de Quervain tendinopathy. Purposes Although this complication has been reported following a resection athroplasty, we questioned whether lengthening of the thumb following the Ivory (Memometal, Stryker Corporate, Kalamazoo, MI, USA) ball-and-socket arthroplasty could be a causal factor. Methods In a prospective study regarding the overall outcome of the Ivory prosthesis, we analyzed 96 cases (83 patients; 69 female, 12 male, 8 bilateral) of primary implanted Ivory prosthesis and the incidence of de Quervain disease during the first year following surgery. We found a particularly high incidence (17%) of de Quervain tendinopathy the first year following this ball-and-socket arthroplasty. We measured the lengthening of the thumb radiographically in the group presenting de Quervain and the asymptomatic group and compared this measure between the two groups. Results We did not find any measurable or statistically significant difference between the groups regarding lengthening. Discussion These findings suggest that lengthening of the thumb following ball-andsocket arthroplasty is not a causal factor in the development of de Quervain tendinopathy within one year after surgery.

Outcomes of cementless joint prosthesis versus tendon interposition for trapeziometacarpal osteoarthritis: a prospective study

“…(2013) also reported good outcomes, no dislocations and only one revision due to polythene wear in a prospective study of 22 patients. In another study by the same authors, Goubau et al. (2015) reported 17% of De Quervain tenosynovitis within the first postoperative year.…”

Complications and failures of the trapeziometacarpal Maia® prosthesis: A series of 156 cases

“…The Goubau et al study [29] also reported a 17% rate of De Quervain's tenosynovitis. These complications generally occur around the 3rd month and although not very serious, they delay functional recovery.…”

“…De Quervain's tenosynovitis occurs when patients resume their activities and use their hand more. The alignment of the thumb column, its lengthening (increased postoperative scaphometacarpal index) [29] and the increased tension on tendon structures may have caused of these tenosynovitis cases.…”

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

“…Side effects such as trigger thumb or de Quervain's disease were also mentioned in other surgical procedures. 24 We think that one reason could be the restricted movement postoperatively due to wearing a thumb orthosis for 4 weeks. Therefore, we shortened this postoperative treatment to 2 weeks.…”