Arthroscopy-Assisted Surgery for Trapeziometacarpal Osteoarthritis.

Shigekazu Fujimura, Shohei Omokawa, Hideo Hasegawa, Kenji Kawamura, Yasuaki Nakanishi, Yasuhito Tanaka
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Abstract

Background: Functional outcomes of patients who underwent arthroscopy-assisted surgery for trapeziometacarpal osteoarthritis were reported. Methods: We included 24 consecutive patients (6 males and 18 females) who underwent surgery and postoperative hand therapy at our hospital between April 2012 and March 2018. For functional evaluation, we used the Purdue Pegboard Test (PPT), grip and pinch strength, range of motion of the thumb, visual analogue scale (VAS) for thumb pain, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Japanese version of the Patient-Rated Wrist Evaluation (PRWE-J) preoperatively and 3 months postoperatively. Results: The mean PPT rating improved from 12.3 to 13.3, the VAS score from 51 to 16, the QuickDASH score from 48 to 30 and the PRWE-J score from 55 to 29. All the improvements were statistically significant. There was a moderate positive correlation between the magnitude of improvement in PPT and QuickDASH scores. Conclusions: Arthroscopic intervention and associated hand therapy were effective in achieving early postoperative relief of thumb pain and in improving hand dexterity and activities of daily living. Level of Evidence: Level IV (Therapeutic).

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关节镜辅助手术治疗掌骨骨关节炎
背景:报告了接受关节镜辅助手术治疗掌骨骨关节炎的患者的功能疗效。手术方法我们纳入了 2012 年 4 月至 2018 年 3 月期间在我院接受手术和术后手部治疗的 24 例连续患者(男 6 例,女 18 例)。在功能评估方面,我们在术前和术后 3 个月使用了普渡钉板测试(PPT)、握力和捏力、拇指活动范围、拇指疼痛视觉模拟量表(VAS)、手臂、肩部和手部快速残疾(QuickDASH)以及日文版患者评定腕关节评估(PRWE-J)。结果显示平均 PPT 评分从 12.3 分提高到 13.3 分,VAS 评分从 51 分提高到 16 分,QuickDASH 评分从 48 分提高到 30 分,PRWE-J 评分从 55 分提高到 29 分。所有这些改善都具有显著的统计学意义。PPT 和 QuickDASH 评分的改善程度呈中度正相关。结论关节镜干预和相关手部治疗可有效缓解术后早期拇指疼痛,并改善手部灵活性和日常生活活动能力。证据等级:IV级(治疗)。
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