Arthroplasty for trapeziometacarpal arthrosis

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Rheumatology

Background:

• Trapeziometacarpal arthrosis is a common cause of thumb pain and dysfunction.
• Ligament reconstruction arthroplasty is a surgical option for managing this condition.

Purpose of the Study:

• To evaluate the subjective and objective outcomes of ligament reconstruction arthroplasty for trapeziometacarpal arthrosis.
• To assess pain relief, functional recovery, patient satisfaction, and range of motion after surgery.

Main Methods:

• A retrospective study of 28 patients (30 thumbs) who underwent ligament reconstruction arthroplasty.
• Data collected included patient demographics, follow-up duration, subjective pain scores, return to work/activity, patient satisfaction, and objective measures of thumb mobility and strength.

Main Results:

• 97% of patients reported excellent or good pain relief, and 98% returned to their previous activity level.
• Overall patient satisfaction was high (86%), primarily attributed to pain relief.
• Thumb mobility improved, but key pinch strength decreased by 27%. Proximal migration of the thumb metacarpal was observed.
• Thumb metacarpophalangeal joint hyperextension was noted in over 50% preoperatively and in 7 thumbs postoperatively, particularly in women on hormone replacement therapy.

Conclusions:

• Ligament reconstruction arthroplasty is an effective treatment for trapeziometacarpal arthrosis, providing significant pain relief and functional improvement.
• While pinch strength may decrease, the overall benefits of pain reduction and return to activity lead to high patient satisfaction.
• Metacarpophalangeal joint hyperextension warrants further investigation, especially in specific patient populations.