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You are here: Home / Uncategorized / Trapeziectomy for trapeziometacarpal osteoarthritis

March 28, 2021

Trapeziectomy for trapeziometacarpal osteoarthritis

Systematic Review of Outcomes and Complications at Minimum Five-Year Follow-Up –

Article published in the Bone & Joint Journal (BJO), March 2021.

Aims

The objective of this systematic review was to describe trapeziectomy outcomes and complications in the context of osteoarthritis of the base of the thumb after a five-year mini- mum follow-up.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide study design, and 267 full-text articles were assessed for eligibility. After exclusion criteria application, 22 studies were included, involving 728 patients and 823 trapeziectomies. Outcomes included pre and postoperative clinical and radiological characteristics. Complications and revisions were recorded.

Results

All the studies reported good results regarding pain and range of motion at the last follow-up of 8.3 years (5 to 22); the mean satisfaction rate was 91% (84% to 100%). It was difficult to assess the impact on metacarpophalangeal joint motion in extension with contrary results. The key pinch returned to its preoperative values, whereas tip pinch showed a modest improvement (+14%), with a mild improvement found in grip strength (+25%) at the last follow-up. The mean progressive trapezial collapse was 48% (0% to 85%) and was not correlated with pain, grip strength, or satisfaction. The most represented complications were linked to tendons or nerves affected during additional procedures to stabilize the joint (11.6%; n = 56). Mechanical complications included symptomatic scapho-M1 impingement (3.1%; n = 15/580), leading to nine surgical revisions out of 581 trapeziectomies. Meta-analysis was not possible due to study heterogeneity and limited data.

Conclusion

After a minimum five-year follow-up, trapeziectomy achieved high patient satisfaction and pain relief. However, strength seemed to be deteriorating with detrimental consequences, but this did not correlate with trapezial collapse. The issues related to underestimating mechanical complications and varying degrees of success should be highlighted in the information given to patients. Evidence-based analyses should help the surgeon in their decision-making.

Read the full article by M. Saab, G. Chick

Article by Grégoire Chick / Uncategorized

Grégoire Chick

dr-chickGrégoire Chick is Consultant Hand Surgeon in Hôpital de la Tour (Geneva) and Clinique de Genolier, Switzerland, and Visiting Surgeon in Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
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The Geneva Hand & Wrist Specialist team consists of surgeons and hand therapists who work together in privates practices located in Geneva and Genolier.

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