Trapeziectomy and ligament reconstruction tendon interposition after failed trapeziometacarpal joint replacement

Hand Surg Rehabil. 2016 Feb;35(1):21-6. doi: 10.1016/j.hansur.2015.09.002. Epub 2016 Feb 16.

Abstract

Total trapeziometacarpal (TMC) joint replacement is increasingly being performed for the treatment of basal joint arthritis. However, complications such as instability or loosening are also frequent with TMC ball-and-socket joint replacement. Management of these complications lacks consensus. The purpose of this study was to report the results of 12 cases of failed TMC joint replacement that were treated by trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. The follow-up consisted of functional (numerical scale, DASH score, satisfaction), physical (range of motion, strength) and radiological (Barron and Eaton ratio measurement) assessments. At a mean follow-up of 21 months, 11 patients were satisfied or very satisfied after surgery. The mean pain score was 2/10 and the mean DASH score 30/100. Mean thumb palmar and radial abduction was 40°. Thumb opposition measured by the Kapandji technique was 9/10. The height ratio was slightly increased. Trapeziectomy with LRTI after TMC joint replacement appears to be an attractive salvage procedure.

Keywords: LRTI; Ligamentoplastie; Ligamentoplasty; Prothèse trapézo-métacarpienne; Revision; Révision; TITL; Trapeziectomy; Trapeziometacarpal arthroplasty; Trapézectomie.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement*
  • Female
  • Humans
  • Ligaments, Articular / surgery*
  • Metacarpal Bones / surgery*
  • Middle Aged
  • Osteoarthritis / surgery
  • Patient Satisfaction
  • Postoperative Complications / surgery*
  • Reconstructive Surgical Procedures / methods
  • Reoperation / methods*
  • Tendons / surgery*
  • Trapezium Bone / surgery*
  • Treatment Outcome