Excisional Arthroplasty for Isolated Scaphotrapeziotrapezoidal Arthritis with the Use of Palmaris Longus Tendon

Background: Isolated scaphotrapeziotrapezoidal (STT) joint osteoarthritis (OA) is a relatively common condition. Scaphotrapeziotrapezoidal arthrodesis is the traditional treatment, while excisional arthroplasty with the use of flexor carpi radialis (FCR) or polycarbon implants represents a promising alternative surgical management. The present study aims to assess a novel alternative technique of excisional arthroplasty with the use of palmaris longus (PL) tendon as interposition material. Materials: The present research is a retrospective observational study. Patients suffering from symptomatic isolated STT OA, without midcarpal instability and treated with excisional arthroplasty with the use of PL tendon as interposition material, were evaluated. Five patients (two males and three females) with mean age of 63.8 years [standard deviation (SD)=16.9] were included. The mean follow up was 56.4 months (SD=9.8). In order to quantify the clinical results, we used the preoperative and postoperative visual analogue scale (VAS) score at rest and during activity, abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and postoperative ROM. Results:The postoperative VAS score at rest and during activity showed a decrease of 86.2% and 62.5%, respectively, when compared to the preoperative one. Regarding postoperative ROM at final follow-up, patients had a mean wrist flexion 71° compared to 78° of the contralateral hand, while the mean extension was found to be 57° compared to 66° of the contralateral side. Conclusions:The evaluated novel technique with the use of PL tendon as interposition material seems to offer satisfying results, while allowing to keep the FCR tendon intact. More studies comparing these techniques are of utmost importance to conclude which is the optimal treatment.