Comparison of arthrodesis and arthroplasty in patients with thumb carpometacarpal osteoarthritis

Abstract

Objective To compare the effect of arthrodesis and arthroplasty in patients with thumb carpometacarpal osteoarthritis, and to compare the advantages and disadvantages of the two methods. Methods From February 2012 to September 2017, 39 patients with phases Ⅱ and Ⅲ thumb carpometacarpal osteoarthritis underwent surgical treatment. 22 cases were performed with trapeziometacarpal arthrodesis and 17 cases were performed with trapezial excision arthroplasty with ligament reconstruction and tendon interposition (LRTI). Postoperatively, objective and subjective evaluation were performed on the two groups, respectively. The objective evaluation included grip strength, pinch strength, thumb abduction degree (palmer and radial), Kapandji opposition score. The subjective evaluation included visual analogue scale (VAS), Disabilities of the Arm, Shoulder and Hand (DASH) score. The data of the two methods were compared and their differences were observed. Results In the comparison between arthrodesis and arthroplasty group, the differences of pinch strength, thumb abduction degree (palmer and radial), Kapandji opposition score were obvious, but there was no significant difference in grip strength, VAS and DASH score. Conclusion For patients with progressive thumb carpometacarpal osteoarthritis, carpometacarpal arthroplasty or arthroplasty can significantly relieve joint pain and improve grip strength. Arthrodesis can improve thumb pinch strength better, while arthroplasty can improve thumb mobility better. The patients are consciously satisfied with the effects of the two surgical methods. Key words: Thumb; Carpometacarpal joints; Arthrodesis; Arthroplasty