Trapeziectomy With a Tendon Tie-in Implant for Osteoarthritis of the Trapeziometacarpal Joint

Abstract

Purpose: To evaluate the early to mid-term clinical and radiological outcomes of trapeziectomy with a tendon tie-in trapezium implant arthroplasty for moderate to severe trapeziometacarpal (TMC) joint osteoarthritis (Eaton stages III to IV).

Methods: We assessed all patients who underwent trapeziectomy and tendon tie-in trapezium implant arthroplasty stabilized with a Weilby flexor carpi radialis tendon sling for osteoarthritis of the TMC joint between 2008 and 2010 at our institution. Twenty-two patients (28 thumbs) who had had an operation at least 12 months earlier were clinically evaluated at an average follow-up of 18 months. Subjective clinical outcomes evaluation included visual analog scale scores and Disabilities of the Arm, Shoulder, and Hand score questionnaires. Objective clinical evaluation included lateral pinch and grip tests and active thumb range of motion. All patients underwent a radiological assessment by 2 independent musculoskeletal radiologists. In cases of unilateral treatment, we compared clinical results obtained from the operated hands with the contralateral hand.

Results: The mean preoperative visual analog scale score of the cohort was 7.4. We documented a statistically significant improvement to 1.2 at a mean of 18 months after the operation (range, 12-26 mo). The mean postoperative Disabilities of the Arm, Shoulder, and Hand score was 21. Thumb palmar abduction was 85°; thumb metacarpophalangeal joint flexion and TMC joint extension were 30° and 10°, respectively. There were 2 cases of prosthesis removal owing to implant dislocation. No late complications were recorded.

Conclusions: Good short-term to mid-term results and stability of TMC arthroplasty implant can be achieved with tie-in trapezium implant stabilized with a Weilby flexor carpi radialis tendon sling.

Type of study/level of evidence: Therapeutic IV.

Keywords: Trapezial metacarpal joint; osteoarthritis; tie-in trapezium implant.