The Role of Arthroscopy in Evaluating and Treating Trapeziometacarpal Disease

Culp, Randall W.; Rekant, Mark S.

doi:10.1016/s0749-0712(21)00251-1

Cited by 91 publications

(20 citation statements)

References 11 publications

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“…Perioperative immobilisation and recovery time are minimised and complications are infrequent (Menon, 1996). Others have demonstrated minimal complications and outcomes that compare favourably with open techniques (Culp and Rekant, 2001;Menon, 1996). Our series confirms the findings of others that arthroscopic debridement and interposition arthroplasty of the first carpometacarpal joint is a viable surgical option for patients with first carpometacarpal joint arthritis refractory to conservative management.…”

Section: Discussionsupporting

confidence: 82%

“…Outcomes in our series also compare favourably to those of other arthroscopic techniques, which have provided satisfactory outcomes in several series (Culp and Rekant, 2001;Menon, 1996;Swafford, 2005). Braun et al (2001) described an arthroscopic technique of debridement and interposition of palmaris longus or FCR tendon harvested through small incisions.…”

Section: Discussionsupporting

confidence: 67%

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Arthroscopic Interposition Arthroplasty of the First Carpometacarpal Joint

Adams

Merten

Steinmann

2007

J Hand Surg Eur Vol

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First carpometacarpal joint arthritis is a common condition encountered by hand surgeons. Traditionally, surgical approaches have included arthrodesis, trapeziectomy or reconstructive arthroplasty techniques. Previously, we described a technique for arthroscopic debridement and interposition arthroplasty of the first carpometacarpal joint. Patients with Eaton stages II and III symptomatic first carpometacarpal joint arthritis recalcitrant to >6 months of non-operative therapy underwent arthroscopic debridement of the first carpometacarpal joint with interposition of an acellular dermal matrix allograft (GRAFTJACKET). In this paper, we describe outcomes following this procedure. Postoperatively, all patients reported symptomatic relief and 94% stated that they were partially, or completely, satisfied. More than 70% of patients reported no to mild difficulty in performing activities of daily living (average grip strength = 18.5 kg, pinch strength = 3.9kg). Complications were minimal. Outcomes from this study compare favourably to those of other series, demonstrating that this technique is a viable option for treatment of Eaton stages II and III first carpometacarpal arthritis.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 67%

Arthroscopic Interposition Arthroplasty of the First Carpometacarpal Joint

Adams

Merten

Steinmann

2007

J Hand Surg Eur Vol

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“…An arthroscopic hemitrapeziectomy with capsular shrinkage (Edwards and Ramsey 2010;Hofmeister et al, 2009;Menon, 1996) has been described recently but the data are limited. It is a technically demanding, time-consuming and costly procedure, which is not suitable for all patients (Hofmeister et al, 2009), and subsidence of the first metacarpal of 2-4 mm has been reported (Culp and Rekant, 2001).…”

Section: Discussionmentioning

confidence: 99%

Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis

Rubino

Civani

Pagani

et al. 2012

J Hand Surg Eur Vol

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We describe a technique that arose from the observation of the clinical outcome of failed arthrodeses of the thumb carpometacarpal joint. In these cases a pseudoarthrosis developed which, surprisingly, rarely lead to a poor clinical outcome. Thus we developed a simple technique which deliberately caused the formation of a narrow pseudoarthrosis in the carpometacarpal joint. We present a retrospective review of 248 consecutive patients treated for Eaton stages II and III osteoarthritis. We observed a statistically significant improvement in mean appositional and oppositional pinch strength, mean DASH score (63.8 pre-operatively to 10.5 at final follow-up), and the mean pain score (8.3 to 0.2). We conclude that trapeziometacarpal limited excision arthroplasty is a simple and reliable alternative to existing surgical techniques for treating Stage II or III thumb carpometacarpal joint arthritis.

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“…Patient satisfaction was assessed in 10 studies via a variety of metrics. 32 38 41 42 43 47 48 57 60 62 In these studies, 83.5 to 100% of patients reported that they were at least satisfied with their arthroscopic procedure. 38 41 42 43 48 60 62…”

Section: Resultsmentioning

confidence: 98%

“…Twenty-two studies (with 23 sets of data) met the inclusion and exclusion criteria and thus were included in the analysis 28 29 32 38 39 41 42 43 44 45 46 47 48 49 50 51 52 60 61 62 63 64 to compare postoperative outcomes between the different techniques ( Table 1 ). In the trapeziectomy versus debridement alone subgroup analysis, the trapeziectomy subgroup contained 16 studies, 28 29 38 39 41 42 43 45 46 47 48 49 51 52 60 62 and the debridement subgroup contained six studies. 32 44 50 61 63 64 In the trapeziectomy alone versus interposition and suspension analysis, the trapeziectomy alone group contained four studies, 38 42 45 62 the interposition had eight studies, 39 41 42 46 47 48 52 60 and suspension had five studies.…”

Section: Resultsmentioning

confidence: 99%

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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The Role of Arthroscopy in Evaluating and Treating Trapeziometacarpal Disease

Cited by 91 publications

References 11 publications

Arthroscopic Interposition Arthroplasty of the First Carpometacarpal Joint

Arthroscopic Interposition Arthroplasty of the First Carpometacarpal Joint

Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis

Treatment of First Carpometacarpal Osteoarthritis with Arthroscopy: A Systematic Review

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