Functional outcome of trapeziometacarpal prostheses in pan-trapezial osteoarthritis.

Hubert Caignol, Anaïs Delgove, Marie-Laure Abi-Chahla, Clotilde Strugarek, Alison Delesque, Hugo Pelet
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Abstract

Trapeziometacarpal osteoarthritis is frequently associated with scaphotrapeziotrapezoid osteoarthritis. Long-term outcomes have not been reported for trapeziometacarpal protheses in patients with radiological pan-trapezial osteoarthritis that is symptomatic only in the trapeziometacarpal compartment. The primary objective of this retrospective multicenter multi-operator study was to evaluate the effectiveness of trapeziometacarpal arthroplasty for pain relief in patients with radiographic pan-trapezial osteoarthritis without symptomatic scaphotrapeziotrapezoid involvement. A total of 70 thumbs in 67 patients were evaluated by a single independent operator at a mean follow-up of 58 months. Scaphotrapeziotrapezoid osteoarthritis severity on Crosby score was stage II in 84% of patients and stage III in 16%. Mean pain score on visual analog scale decreased from 7.7 preoperatively to 1.3 at last follow-up. There were no reoperations at last follow up. These results suggest that, in patients with radiological pan-trapezial osteoarthritis without symptomatic involvement of the scaphotrapeziotrapezoid joint, a trapeziometacarpal prothesis yields good medium-term clinical outcomes. LEVEL OF EVIDENCE: III.

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泛斜骨关节炎的斜骨手骨假体的功能效果。
梯形掌骨骨关节炎常与舟状梯形骨关节炎相关。放射性泛斜骨关节炎患者仅在斜骨掌骨间室出现症状,使用斜骨腕关节假体治疗的长期结果尚未见报道。这项回顾性多中心、多操作者研究的主要目的是评估无症状的舟斜椎体受累的x线平片泛斜骨关节炎患者采用梯形腕关节置换术缓解疼痛的有效性。在平均58个月的随访中,由一名独立操作者对67例患者的70个拇指进行评估。根据Crosby评分,84%的患者舟状梯形骨关节炎严重程度为II期,16%的患者为III期。视觉模拟评分的平均疼痛评分由术前的7.7分降至最后随访时的1.3分。最后随访没有再手术。这些结果表明,在无症状累及舟状斜方-梯形关节的放射学泛斜骨关节炎患者中,斜方-手骨假体具有良好的中期临床效果。证据水平:iii。
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