The surgical management for isolated scaphotrapeziotrapezoid (STT) osteoarthritis : a systematic review of the literature

Acta Orthop Belg. 2020 Mar;86(1):137-145.


We performed a systematic review to find out the safety and efficacy of various procedures for isolated scaphotrapeziotrapezoid osteoarthritis. Eleven articles were included. The most common procedure was arthroplasty with pyrocarbon implant (28%), followed by resection of distal pole of scaphoid with proximal trapezium and trapezoid resection (18%). The other procedures included trapeziectomy with ligament reconstruction and tendon interposition (LRTI) (14%), arthroscopic resection of distal scaphoid (11%), trapezium and trapezoid resection with LRTI (10%) and arthrodesis (10%). Complications were noted in 18 (15%) patients. The most common complication (7.5%) was asymptomatic dorsal intercalated segmental instability (DISI) followed by dislocation of the pyrocarbon implant (3%). Fusion resulted in decreased range of motion and grip strength. The distal scaphoid resection was related to high rate of DISI. Although the pyrocarbon implant has a higher dislocation rate which requires revision surgery, this complication is avoidable with good surgical technique. Arthroplasty with pyrocarbon implant may be the first choice in younger patients.

Publication types

  • Systematic Review

MeSH terms

  • Arthroplasty, Replacement
  • Humans
  • Ligaments, Articular / surgery
  • Osteoarthritis / surgery*
  • Scaphoid Bone / surgery*
  • Tendons / transplantation
  • Trapezium Bone / surgery*
  • Trapezoid Bone / surgery*