Outcomes of Revisions for Failed Trapeziometacarpal Joint Arthritis Surgery

Outcomes and recommendations for revision of thumb carpometacarpal resection arthroplasty

“…This is in contrast to the findings of a small matched-pair study showing neither any differences in pain nor hand function between patients after trapeziectomy for failed implant arthroplasty or primary trapeziectomy (Kaszap et al, 2013). Nevertheless, our scores are in line with or slightly better than those reported by other groups reporting on pain (lying between 2.8 and 4.2 on the numeric rating scale) after revision surgery (Mattila and Waris, 2019;Megerle et al, 2011;Munns et al, 2019).…”

“…Only a few studies have investigated thumb CMC revision surgery and shown satisfactory outcomes; 50% to 75% of patients undergoing this procedure can expect good results (Cooney et al, 2006;Munns et al, 2019). However, the outcomes of revision surgery seem to be inferior to that of primary surgery (Munns et al, 2019;Sadhu et al, 2016). 1 To date, there has been a lack of clear guidelines advocating how patients with residual symptoms after trapeziectomy should be evaluated and treated further.…”

“…Trapezium resection alone or with ligament reconstruction and tendon interposition (LRTI) offers considerable pain relief and functional restoration in patients with thumb carpometacarpal (CMC) osteoarthritis (OA) (Vermeulen et al., 2011; Wajon et al., 2015; Yeoman et al., 2019). Despite the mainly good outcomes, 2.5% to 5% of patients require revision surgery due to persistent pain, instability, subsidence of the first metacarpal (MC) bone, weakness and/or untreated peritrapezial or other midcarpal OA (Cooney et al., 2006; Hess et al., 2018; Mattila and Waris, 2019; Munns et al., 2019). Younger patients tend to have a higher risk for revision surgery than older patients (Mattila and Waris, 2019).…”

Metacarpophalangeal Arthrodesis with Resection-suspension Arthroplasty in First Carpometacarpal Osteoarthritis

“…6 La hiperextensión MCF sola o asociada con el choque entre el primer MC contra el remanente carpiano es causa de revisión de la trapecectomía. 7,8 Para evitar llegar a la cirugía de revisión lo ideal es tratar la articulación MCF en el mismo momento que la TMC, si se va a resecar el trapecio. Se han propuesto diferentes técnicas quirúrgicas para asociar cuando la hiperextensión supera los 30°, entre las que se incluyen la estabilización temporal con agujas (con pobres resultados), la capsulodesis volar, la transferencia a próximal y radial del extensor pollicis brevis (EPB) en el primer MC, la fusión de los sesamoideos (con la que se pierden de extensión) o la artrodesis de la articulación MCF.…”

Komplikationsmanagement nach Resektionsarthroplastik bei Daumensattelgelenkarthrose

“…Bei einem operativen Behandlungsversuch sollten Patienten zusätzlich auch über eine etwaige Verschlechterung der Symptomatik aufgeklärt werden. [24].…”