Comparison of arthrodesis and arthroplasty of Chinese thumb carpometacarpal osteoarthritis
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(2019) 14:404
RESEARCH ARTICLE
Open Access
Comparison of arthrodesis and arthroplasty of Chinese thumb carpometacarpal osteoarthritis Jianfeng Li*, Dacun Li, Guanglei Tian and Wentong Zhang
Abstract Background: The thumb carpometacarpal (CMC) osteoarthritis is very common. Multiple methods are used to treat progressive thumb CMC osteoarthritis, among which trapeziometacarpal arthrodesis and trapezial excision with ligament reconstruction and tendon interposition (LRTI) are the most common. These two surgical treatment methods have received mixed reviews in previous studies in the west patients. This retrospective study studied the effects, advantages, and disadvantages of arthrodesis and arthroplasty for treating thumb carpometacarpal osteoarthritis in Chinese patients. Methods: Between February 2012 and September 2017, 39 Chinese patients with stage II or III thumb carpometacarpal osteoarthritis underwent surgery (trapeziometacarpal arthrodesis in 22, trapezial excision with ligament reconstruction and tendon interposition in 17). Postoperative objective and subjective evaluations were performed. The objective evaluation involved grip strength, pinch strength, thumb abduction degree (palmar and radial), and Kapandji opposition scores. The subjective evaluation involved visual analog scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Results: Intergroup differences in pinch strength, thumb abduction degrees (palmar and radial), and Kapandji opposition scores were obvious, whereas those in grip strength, VAS score, and DASH score were not. Conclusion: In Chinese patients, both techniques relieved pain and improve grip strength. Arthrodesis displayed better pinch strength, while arthroplasty displayed better motor function. Patients were satisfied with the effects of both techniques. Keywords: Thumb, Carpometacarpal joint, Arthrodesis, Arthroplasty
Background The thumb carpometacarpal (CMC) joint is a saddle joint with both concave and convex surfaces and a thin and loose capsule. Due to the effect of constant multidirectional forces during daily work and life activities, about 25% of females and 12% of males suffer from thumb CMC osteoarthritis in the west [1]. Symptoms of thumb CMC osteoarthritis include pain, swelling, deformity, and instability. Multiple methods are used to treat progressive thumb CMC osteoarthritis, among which trapeziometacarpal arthrodesis and trapezial excision with * Correspondence: [email protected] Department of Upper Limb Surgery, Beijing Shunyi District Hospital, No.3 guangming south street, shunyi district, Beijing 101300, People’s Republic of China
ligament reconstruction and tendon interposition (LRTI) are the most common. These two surgical treatment methods have received mixed reviews in previous studies in the west patients. This retrospective study studied the results of 39 Chinese patients of progressive thumb CMC osteoarthritis treated with either arthrodesis or arthroplasty. Through the evaluation of grip strength, pinch strength, thumb abduction an
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