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Published on: May 14, 2020
The Artelon CMC spacer compared with tendon interposition arthroplasty
Anders Nilsson1, Monica Wiig, Håkan Alnehill
1Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg. anders.g.nilsson@vgregion.se
Acta Orthopaedica
|February 26, 2010
Summary
The Artelon CMC spacer did not outperform tendon arthroplasty for thumb osteoarthritis. Careful patient selection and preoperative antibiotics are crucial for optimal outcomes in CMC joint surgery.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Biomaterials Science
Background:
- Osteoarthritis (OA) of the carpometacarpal joint of the thumb (CMC-I) is a common condition requiring surgical intervention.
- The Artelon CMC spacer is a degradable device developed for CMC-I OA treatment.
- Previous pilot studies suggested positive outcomes for the Artelon CMC spacer.
Purpose of the Study:
- To compare the efficacy of the Artelon CMC spacer against tendon arthroplasty in treating painful CMC-I OA.
- To evaluate outcomes including pain, pinch strength, range of motion, and functional status.
- To assess the impact of patient selection and perioperative protocols on treatment results.
Main Methods:
- A randomized, controlled, multicenter study involving 109 patients with symptomatic CMC-I OA.
- Patients were randomized 2:1 to receive either an Artelon CMC spacer (test group, n=72) or tendon arthroplasty (control group, n=37).
- Primary outcome measure was maximal tripod pinch strength at 12 months; secondary outcomes included pain (VAS), range of motion, radiographic findings, and DASH scores.
Main Results:
- Swelling and pain were more frequent in the Artelon CMC spacer group, leading to 6 implant removals.
- In per-protocol analysis, the Artelon group showed a non-significant 1.4 kg increase in pinch strength compared to the control group.
- Both groups experienced significant pain relief and improvement in patient-perceived disability (DASH scores), with the control group showing better pain relief in intention-to-treat analysis.
Conclusions:
- The Artelon CMC spacer did not demonstrate superior outcomes compared to tendon interposition arthroplasty for CMC-I OA.
- The study highlights the importance of appropriate patient selection and the use of preoperative antibiotics for successful outcomes.
- Further research may be needed to optimize the use of the Artelon CMC spacer or identify specific patient subgroups who benefit most.
