治疗拇指骨关节炎的新技术。

IF 2.6 2区 医学 Q1 ORTHOPEDICS Journal of the American Academy of Orthopaedic Surgeons Pub Date : 2024-10-01 DOI:10.5435/JAAOS-D-23-01059
Gilad Rotem, Assaf Kadar
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引用次数: 0

摘要

第一腕掌(CMC)关节无症状性骨关节炎(OA)发病率高且使人衰弱,常见于老年人和绝经后人群。这篇综述重点介绍了治疗拇指 CMC OA 的最新进展,该疗法历来包括一系列非手术和手术方案,但没有达成共识的基准。我们将重点关注创新和新兴技术。非手术疗法通常包括定制支架和皮质类固醇注射。此外,本综述还探讨了一些先进的方法,如提高了患者满意度的 3D 打印矫形器,以及通过超声波优化以提高治疗精度和效果的新型关节内注射剂(如自体脂肪)。虽然标准的手术治疗方法包括梯形切除术、韧带重建术或肌腱插植术,但最新的植入关节成形术设计显示了良好的长期存活率。较新的干预措施包括针对患者的掌骨截骨器械、选择性关节去神经化和创新的悬吊成形术器械,所有这些措施的特点都是提高精确度和提供个性化护理。但需要注意的是,这些新技术尚未被证实优于拇指CMC OA的标准治疗方法。
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New Technologies in the Treatment of Base of Thumb Osteoarthritis.

Symptomatic osteoarthritis (OA) of the first carpometacarpal (CMC) joint is prevalent and debilitating, commonly affecting the elderly and postmenopausal population. This review highlights the latest advancements in the treatment of thumb CMC OA, which historically includes a range of nonsurgical and surgical options without a consensus benchmark. We will focus on innovative and emerging technologies. Nonsurgical treatments typically comprise custom braces and corticosteroid injections. In addition, this review explores advanced approaches such as 3D printed braces, which have improved patient satisfaction, and novel intra-articular injectables such as autologous fat, optimized by ultrasonography to enhance treatment precision and outcomes. Although standard surgical treatments include trapeziectomy, with or without ligament reconstruction and tendon interposition, more recent implant arthroplasty designs show promising long-term survival. Newer interventions include patient-specific instrumentation for metacarpal osteotomies, selective joint denervation, and innovative suspensionplasty devices, all marked by their increased precision and personalized care. However, it is important to note that these novel technologies are not yet established as superior to standard treatments of thumb CMC OA.

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来源期刊
CiteScore
6.10
自引率
6.20%
发文量
529
审稿时长
4-8 weeks
期刊介绍: The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues. Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.
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