Trapeziectomy versus joint replacement for first carpometacarpal (CMC 1) joint osteoarthritis: a systematic review and meta-analysis

Raj, Siddarth; Clay, Reece; Ramji, Saajan; Shaunak, Raghav; Dadrewalla, Arshan; Sinha, Vikram; Shaunak, Shalin

doi:10.1007/s00590-021-03070-5

Cited by 23 publications

(26 citation statements)

References 39 publications

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“… 29 Implant arthroplasty is prone to early failure. 4 All of the listed methods include substantial downtime with a delayed return to work and orthosis fabrication of around 6 weeks. Carpometacarpal joint denervation, in comparison, has minimal downtime.…”

Section: Discussionmentioning

confidence: 99%

“… 1 There are a spectrum of surgical options for patients with CMC arthritis, including CMC arthroscopy with debridement, trapeziectomy with or without ligament reconstruction and tendon interposition, trapeziectomy with implant suspensionplasty, arthrodesis, and implant arthroplasty. 3 , 4 , 5 While these procedures are associated with improvements in pain and functional outcomes, there is a substantial risk of postoperative complications, such as tendon rupture; loosening, extrusion, or failure of protheses; and worsening carpal instability. A review of the literature shows that rates of adverse outcomes or postoperative complications can be as high as 22%.…”

mentioning

confidence: 99%

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Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Follow-Up of Long-Term Clinical Outcomes

Suresh¹,

Frost²,

Lifchez³

2023

Journal of Hand Surgery Global Online

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Follow-Up of Long-Term Clinical Outcomes

Suresh¹,

Frost²,

Lifchez³

2023

Journal of Hand Surgery Global Online

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“…Higher medium-term key pinch strength seems to be a great advantage of a TMJ implant arthroplasty (Lee et al, 2021;Raj et al, 2022). The higher strength achieved after Touch V R implant arthroplasty can be explained by the ability of this device to restore biomechanical function.…”

Section: Discussionmentioning

confidence: 99%

Short-term recovery after implant versus resection arthroplasty in trapeziometacarpal joint osteoarthritis

Herren

Marks

Neumeister

et al. 2023

J Hand Surg Eur Vol

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We compared the short-term recovery of patients treated with trapeziometacarpal joint (TMJ) implant arthroplasty versus resection-suspension-interposition (RSI) arthroplasty. Implant patients ( n = 147) had a better 3-month postoperative brief Michigan Hand Outcomes Questionnaire (MHQ) score (mean 82) compared to RSI patients ( n = 127), who had a mean score of 69. Key pinch strength at 3 months was also higher in the implant group compared to the RSI group (6.8 kg vs. 3.1 kg). At 1 year, both groups had similar brief MHQ scores, but key pinch remained higher in the implant group (7.0 kg vs. 3.9 kg [RSI]). After implant arthroplasty, employed patients returned to work after a mean of 44 days, which was significantly faster than the 84 days for RSI patients. Patients after TMJ implant arthroplasty recover significantly faster in the first 3 postoperative months compared to RSI patients. However, 1-year postoperative outcomes are similar for both cohorts, with key pinch strength remaining higher for patients with TMJ implant arthroplasty. Level of evidence: II

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“…71 All surgical techniques have demonstrated efficacy in pain relief and functional improvement. [72][73][74] A 2015 Cochrane review by Wajon et al 73 reported that of 7 surgical techniques, none was associated with better outcomes than alternative techniques for outcomes of functioning and pain.…”

Section: Treatment and Outcomesmentioning

confidence: 99%

“…In the US, the most commonly performed technique is trapeziectomy with ligament reconstruction and tendon interposition (>90%), followed by trapeziectomy alone, joint replacement, and fusion, all performed at a similar frequency . All surgical techniques have demonstrated efficacy in pain relief and functional improvement . A 2015 Cochrane review by Wajon et al reported that of 7 surgical techniques, none was associated with better outcomes than alternative techniques for outcomes of functioning and pain.…”

Section: Thumb Cmc Joint Arthritismentioning

confidence: 99%

Common Hand Conditions

Currie

Tadisina

Mackinnon

2022

JAMA

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ImportanceCarpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, and basilar (carpometacarpal) joint arthritis of the thumb can be associated with significant disability.ObservationsCarpal tunnel syndrome is characterized by numbness and tingling in the thumb and the index, middle, and radial ring fingers and by weakness of thumb opposition when severe. It is more common in women and people who are obese, have diabetes, and work in occupations involving use of keyboards, computer mouse, heavy machinery, or vibrating manual tools. The Durkan physical examination maneuver, consisting of firm digital pressure across the carpal tunnel to reproduce symptoms, is 64% sensitive and 83% specific for carpal tunnel syndrome. People with suspected proximal compression or other compressive neuropathies should undergo electrodiagnostic testing, which is approximately more than 80% sensitive and 95% specific for carpal tunnel syndrome. Splinting or steroid injection may temporarily relieve symptoms. Patients who do not respond to conservative therapies may undergo open or endoscopic carpal tunnel release for definitive treatment. Trigger finger, which involves abnormal resistance to smooth flexion and extension (“triggering”) of the affected finger, affects up to 20% of adults with diabetes and approximately 2% of the general population. Steroid injection is the first-line therapy but is less efficacious in people with insulin-dependent diabetes. People with diabetes and those with recurrent symptoms may benefit from early surgical release. de Quervain tenosynovitis, consisting of swelling of the extensor tendons at the wrist, is more common in women than in men. People with frequent mobile phone use are at increased risk. The median age of onset is 40 to 59 years. Steroid injections relieve symptoms in approximately 72% of patients, particularly when combined with immobilization. People with recurrent symptoms may be considered for surgical release of the first dorsal extensor compartment. Thumb carpometacarpal joint arthritis affects approximately 33% of postmenopausal women, according to radiographic evidence of carpometacarpal arthritis. Approximately 20% of patients require treatment for pain and disability. Nonsurgical interventions (immobilization, steroid injection, and pain medication) relieve pain but do not alter disease progression. Surgery may be appropriate for patients unresponsive to conservative treatments.Conclusions and RelevanceCarpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, and thumb carpometacarpal joint arthritis can be associated with significant disability. First-line treatment for each condition consists of steroid injection, immobilization, or both. For patients who do not respond to noninvasive therapy or for progressive disease despite conservative therapy, surgical treatment is safe and effective.

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Trapeziectomy versus joint replacement for first carpometacarpal (CMC 1) joint osteoarthritis: a systematic review and meta-analysis

Cited by 23 publications

References 39 publications

Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Follow-Up of Long-Term Clinical Outcomes

Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Follow-Up of Long-Term Clinical Outcomes

Short-term recovery after implant versus resection arthroplasty in trapeziometacarpal joint osteoarthritis

Common Hand Conditions

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