Outcome Analysis of Trapezectomy With and Without Pyrocarbon Interposition to Treat Primary Arthrosis of the Trapeziometacarpal Joint

Abstract

We performed a prospective cohort comparative analysis of simple trapezectomy and trapezectomy with pyrocarbon interposition in 38 consecutive patients with trapeziometacarpal joint osteoarthrosis. Patients were assessed preoperatively, at six and 12 months postoperatively using subjective and objective tools. Subjective assessment was performed using the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire and the visual analogue score. Objective assessment was performed with grip strength measurements. At each time interval, statistical differences were sought between the two subgroups. No significant difference between the two subgroups was noted at any time interval on subjective or objective assessment. A significant difference (p < 0.05) was found on comparing the respective preoperative and 12-month subjective scores in both subgroups. Of the pyrocarbon subgroup seven had related complications. We suggest that pyrocarbon interposition does not significantly improve postoperative function, requires a longer operation with a high postoperative risk of pyrocarbon displacement and need for revision surgery.

Simple Trapeziectomy for Arthrosis of the Basal Joint of the Thumb: 49 Thumbs Reviewed After Two Years

“…15) Simple trapeziectomy has been compared favorably with other procedures. [15][16][17][18] In our review outcomes on subjective estimation of pain, DASH, activities of daily living, thumb mobility, strength and radiological distance are similar to our review of the APL procedure. For many outcome parameters there was a trend for better results among the trapeziectomy patients.…”

“…Our findings of good results are supported by other studies on simple trapeziectomy. 9,17,19,20) We conclude that the outcome with simple trapeziectomy is at least as good as with the APL procedure and therefore should be preferred. The possible complication of clumsiness, however, should be investigated further.…”

Early results of a prospective study on the pyrolytic carbon (pyrocarbon) Amandys® for osteoarthritis of the wrist

“…With the timescale of recovery known to be lengthy and often extending beyond a year following the previously mentioned salvage procedures, our early results are encouraging and support the use of the Amandys® as an alternative treatment option for osteoarthritis of the wrist and SLAC. However, with one recent study bringing to light long-term concerns about pyrocarbon and its interface with bone, 18 and another suggesting that pyrocarbon interposition does not significantly improve post-operative function and carries a high post-operative risk of pyrocarbon displacement and need for revision surgery, 19 our early results warrant further and longer studies.…”

Procedimientos quirúrgicos de los miembros de la Sociedad Española de Cirugía de la Mano (SECMA) para la artrosis trapecio-metacarpiana: Un examen de las tendencias de la práctica clínica actual

“…En nuestro estudio encontramos resultados similares a los descritos por Brunton y Wilgis en la Sociedad Americana de Cirugía de la Mano. 5 A pesar de la evidencia aportada en estudios recientes que sugiere que ninguna técnica aporta beneficio adicional sobre la trapezectomía en el tratamiento quirúrgico de la artrosis TMC del pulgar, 6,7 algunos cirujanos las utilizan como procedimiento de elección sin considerar la evidencia científica publicada al respecto. Con respecto al tiempo de inmovilización post-quirúrgica más del 75% de los cirujanos inmovilizan el pulgar durante 1-3 semanas al igual que en estudios previos.…”