A Device for Evaluating Laxity of the Thumb Carpometacarpal Joint

2000 ◽  
Author(s):  
Michael A. Soltz ◽  
Mathew F. Koff ◽  
Eric J. Balaguer ◽  
Robert J. Pawluk ◽  
Robert J. Strauch ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Biochemical Composition ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Quantitative Measurements ◽  
Thumb Carpometacarpal ◽  
Surface Remodeling ◽  
Joint Congruence ◽  
Force Displacement

Abstract It has been proposed that ligamentous laxity promotes osteoarthritis of the thumb carpometacarpal joint. However, quantitative measurements of laxity for this joint have not been correlated with its incidence of osteoarthritis nor with other measures of degenerative changes such as joint congruence, surface remodeling, cartilage mechanical properties or biochemical composition. The goal of this study was to design and build a device for testing the laxity of the carpometacarpal joint, with the long-term aim of advancing our understanding of the etiology of osteoarthritis in this joint. This laxity tester has the ability to accurately measure the force-displacement response along the joint’s dorsal-volar, radial-ulnar, and distraction-reduction directions, as well as the torque-rotation response in pronation-supination. The compliance of the tester was evaluated and laxity curves were generated for a sample thumb carpometacarpal joint.

Results of 115 Rubis II reverse thumb carpometacarpal joint prostheses with a mean follow-up of 10 years

2017 ◽  
Vol 42 (6) ◽  
pp. 592-598 ◽  
Author(s):  
M. Dehl ◽  
M. Chelli ◽  
S. Lippmann ◽  
S. Benaissa ◽  
V. Rotari ◽  
...  
Keyword(s):  
Clinical Results ◽  
Carpometacarpal Joint ◽  
Level Of Evidence ◽  
Thumb Carpometacarpal Joint ◽  
The Mean ◽  
Thumb Carpometacarpal ◽  
Joint Prostheses ◽  
Clinical And Radiological Results

The aim of this study was to assess the clinical and radiological results of the Rubis II thumb carpometacarpal joint reverse prosthesis, at a mean follow-up of 10 years. Between 1997 and 2008, 253 prostheses were implanted in 199 patients; 115 were reviewed. The survival after a mean of 10 years was 89%. At the last follow-up, 70% of prostheses were painless; the others reported moderate or intermittent pain. The satisfaction rate was 98%. The mean opposition was 9 on the Kapandji scale; the mean QuickDASH score was 30. Wrist, key and tip pinch strengths were comparable with the non-operated side. Of the 115 implants, one was radiologically loose (1%) and 15 had suffered dislocations (13%), 12 of which were caused by an injury. Eleven thumbs had revision surgery. This study confirms that the good clinical results of the Rubis II prosthesis are maintained in the medium and long term, and represents a useful alternative to trapeziectomy for selected patients. Level of evidence: IV

Simulated Osteotomy of the Trapezium Reduces Radial Subluxation and Improves Contact Pressure Distribution Across the Thumb Carpometacarpal Joint in Lateral Pinch

2010 ◽  
Author(s):  
Deana Mercer ◽  
Christina Salas ◽  
James Love ◽  
Letitia Lansing ◽  
Amanda Medoro ◽  
...  
Keyword(s):  
Joint Laxity ◽  
Carpometacarpal Joint ◽  
Contact Pressure Distribution ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Long Term Impact ◽  
Flexion And Extension ◽  
Cmc Joint ◽  
Over Time

Joint laxity and radial subluxation of the metacarpal on the trapezium have been associated with arthritis of the carpometacarpal (CMC) joint of the thumb. In normal flexion and extension of the thumb, the ligaments and the joint are minimally stressed. However, in opposition and lateral pinch (key pinch), the two surfaces rotate on each other, generating an unequal surface stress. Over time, the unequal stresses lead to an asymmetrical wear pattern. This leads to increased strain on the ligaments and may lead to subluxation over time.1 Surgical treatment of early arthritis of the CMC joint includes ligament reconstruction or first metacarpal extension osteotomy to decrease joint laxity. Once laxity exists, joint degeneration is accelerated.2 The long-term impact of painful CMC arthritis on activities of daily living can be debilitating.

Ligament reconstruction for the painful thumb carpometacarpal joint: A long-term assessment

1984 ◽  
Vol 9 (5) ◽  
pp. 692-699 ◽  
Author(s):  
Richard G. Eaton ◽  
Lewis B. Lane ◽  
J. William Littler ◽  
John J. Keyser
Keyword(s):  
Ligament Reconstruction ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal

Simple trapeziectomy versus trapeziectomy with flexor carpi radialis suspension: a 17-year follow-up of a randomized blind trial

2020 ◽  
pp. 175319342095296
Author(s):  
Adrian Brennan ◽  
Julia Blackburn ◽  
Jane Thomson ◽  
Jeremy Field
Keyword(s):  
Functional Outcomes ◽  
Ligament Reconstruction ◽  
Carpometacarpal Joint ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition

The purpose of this study was to investigate if there were any significant differences in the long-term outcomes of patients who participated in a randomized trial of trapeziectomy alone compared with trapeziectomy with ligament reconstruction and tendon interposition (LRTI). Sixty-five patients were invited for a follow-up visit at a mean of 17 years (range 15–20) postoperatively. Twenty-eight patients attended, who had 34 operations, 14 trapeziectomy alone and 20 with LRTI. There were no statistically significant differences between the two groups in terms of satisfaction with surgery or functional outcomes, with most measurements showing minimal or no differences in means between the two groups. There was no difference in the space between the metacarpal and scaphoid. Radial abduction was the only parameter that was significantly greater in the patients with simple trapeziectomy (median 79°) compared with trapeziectomy with LRTI (median 71°) ( p = 0.04). Even at 17 years there is no significant benefit of LRTI over trapeziectomy alone for thumb carpometacarpal joint osteoarthritis. Level of evidence: I

scholarly journals Trapezium Fracture Associated with Thumb Carpometacarpal Joint Dislocation: A Report of Three Cases and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Sho Kohyama ◽  
Toshikazu Tanaka ◽  
Akira Ikumi ◽  
Yasukazu Totoki ◽  
Kosuke Okuno ◽  
...  
Keyword(s):  
Carpometacarpal Joint ◽  
Ligament Injuries ◽  
Short Term ◽  
Joint Dislocation ◽  
Thumb Carpometacarpal Joint ◽  
Trapezium Fracture ◽  
Thumb Carpometacarpal ◽  
Treatment Consensus ◽  
Cmc Joint

Isolated trapezium fracture in combination with thumb carpometacarpal (CMC) joint dislocation is extremely rare, and no treatment consensus exists. Herein, we report 3 successfully treated cases of isolated trapezium fracture with thumb CMC joint dislocation. While good short-term results have been reported in the literature, the possibility of substantial ligament injuries that can lead to future instability of the thumb CMC joint must be noted. In order to obtain an excellent long-term clinical result, we propose the consideration of the anatomical repair of the CMC joint in terms of both bony and ligamentous structures in cases where instability remains after fracture fixation.

Arthrodesis of the thumb carpometacarpal joint using a quadrangular plate: surgical technique and long-term results of 70 patients

2017 ◽  
Vol 27 (7) ◽  
pp. 909-915 ◽  
Author(s):  
Verónica Jiménez-Díaz ◽  
David Cecilia-López ◽  
Miguel Ángel Porras-Moreno ◽  
Gema Muñoz-Sánchez ◽  
Lorena García-Lamas ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Long Term Results ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal

Thumb carpometacarpal joint total arthroplasty: a systematic review

2015 ◽  
Vol 40 (4) ◽  
pp. 338-350 ◽  
Author(s):  
K. Huang ◽  
N. Hollevoet ◽  
G. Giddins
Keyword(s):  
Systematic Review ◽  
Carpometacarpal Joint ◽  
Long Term Outcomes ◽  
Short Term ◽  
Thumb Carpometacarpal Joint ◽  
Published Evidence ◽  
Total Arthroplasty ◽  
Thumb Carpometacarpal ◽  
Better Than

Thumb carpometacarpal joint total arthroplasty has been undertaken for many years. The proponents believe the short-term outcomes are better than trapeziectomy and its variants, but the longer term complications are often higher. This systematic review of all peer reviewed articles on thumb carpometacarpal joint total arthroplasty for osteoarthritis shows that there are reports of many implants. Some are no longer available. The reported outcomes are very variable: for some there are good long-term outcomes to beyond 10 years; for others there are unacceptably high early rates of failure. Overall the published evidence does not show that total arthroplasty is better than trapeziectomy and its variants yet there is a higher complication rate and significant extra cost of using an implant. Future research needs to compare total arthroplasty with trapeziectomy to assess short term results where the arthroplasties may be better, long-term outcomes and the healthcare and personal costs so that surgeons and patients can make fully informed choices about the treatment of symptomatic thumb carpometacarpal joint osteoarthritis.

Ten-year long-term results of total joint arthroplasties with ARPE® implant in the treatment of trapeziometacarpal osteoarthritis

2013 ◽  
Vol 39 (8) ◽  
pp. 826-832 ◽  
Author(s):  
M. Martin-Ferrero
Keyword(s):  
Long Term Results ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Kaplan Meier ◽  
Trapeziometacarpal Osteoarthritis ◽  
Thumb Carpometacarpal ◽  
Lost To Follow Up ◽  
Joint Arthroplasties

Between May 1999 and April 2002 a total of 69 consecutive thumb carpometacarpal joint arthoplasties were performed in a total of 64 patients for carpometacarpal joint osteoarthritis using the cementless hydroxyapatite (HA)-coated unconstrained ARPE implant. Clinical, functional and radiological results at 10-year follow-up are presented. Survival analysis was performed using the Kaplan–Meier method. Of the 64 patients, four were lost to follow-up, 60 implants (92.3%) were functional and five (7.7%) were not (two dislocated, two were removed and one with aseptic loosening). Survival estimate for functional implants over 10 years was 93.9% (95% confidence interval 82.3–97.9). The radiographs were satisfactory in 82.4%. There was subsidence of the cup in 15.8%. Thumb carpometacarpal joint arthroplasty with the ARPE implant offers a reliable treatment alternative in patients with Eaton grade III or IV thumb carpometacarpal joint arthritis in the presence of good bone stock.

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