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Revision Trapeziometacarpal Arthroplasty With Acellular Dermal Xenograft
Michael C Doarn1, Mariel McLaughlin McArthur2, John J Fernandez3
1Florida Orthopaedic Institute, Tampa, Florida.
Background:
Osteoarthritis of the trapeziometacarpal joint is common. There are limited surgical options for patients who have undergone a failed primary trapeziometacarpal arthroplasty.
Methods:
The authors conducted a retrospective review of patients who received a porcine dermal graft for failed trapeziometacarpal arthroplasty. Three hundred fifty-five trapeziometacarpal procedures were performed from 2005 to 2015; 9 were revisions. Seven were performed with xenograft interposition. Data included primary procedure, grip and key pinch strength, Visual Analog Score (VAS), motion, time to return to work, Kapandji Score, and radiographs.
Results:
The mean follow-up was 84 weeks. The mean VAS score was 2.3, and all patients reported notable improvement. The mean Kapandji Score was 8. The mean grip was 20 kg, and the mean key pinch was 5 kg in the operated hand. The mean time to return to work was 12 weeks. The final radiographs showed improvement in spaces. No complications or immunological reactions were encountered.
Conclusions:
The authors describe a technique for revision trapeziometacarpal arthroplasty with a porcine xenograft acellular dermal matrix. This technique shows a safe and valid treatment option with acceptable clinical outcomes.