scholarly journals Functional outcome of ligament reconstruction with tendon interposition after failed first carpometacarpal joint prosthesis

2021 ◽  
Vol 87 (1) ◽  
pp. 137-142
Author(s):  
Lyne Anthonissen ◽  
Elke Van Eynde ◽  
Maarten Van Nuffel ◽  
Luc De Smet
Keyword(s):  
Functional Outcome ◽  
Grip Strength ◽  
Ligament Reconstruction ◽  
Strength Loss ◽  
Contralateral Side ◽  
Joint Prosthesis ◽  
Carpometacarpal Joint ◽  
First Carpometacarpal Joint ◽  
Quick Dash ◽  
Tendon Interposition

The purpose is to determine if ligament reconstruction with tendon interposition (LRTI) is a recommendable salvage option for failed total joint prosthesis of the first carpometacarpal joint. Twenty-two patients in our database met the in- clusion criteria for this retrospective study, with at least 6 months follow-up. Fourteen participated and were invited for a clinical examination and asked to fill out two questionnaires. They were evaluated for pain (VAS), impairment (NHS), disability (Quick DASH), opposition (Kapandji test) and grip strength (hydraulic dynamometer). Results of the questionnaires were compared to a cohort study of primary LRTI’s. Kapandji test and grip strength were compared to the contralateral side. Compared to primary LRTI’s, revision surgery showed mild deterioration of impairment and disability. The average VAS score was 2.9 out of 10. Twelve patients mentioned a sense of strength loss, which could be quantified with the dynamometer : a mean of 15.1 kg (operated thumb) versus 20.5 kg (contralateral). There was a relatively small decline of opposition with Kapandji 8.6 versus 9.9. The overall satisfaction was good for 8 patients, fair for 3 and poor for the remaining 3 (mainly based on strength loss). One patient needed a second revision. Failed first carpometacarpal joint replacement can be salvaged by ligament reconstruction with tendon interposition, providing an acceptable functional outcome in 79% of cases studied. However, compared to the functional outcome of primary LRTI’s, mild aggravation of impairment and disability should be taken into account.

The effect of custom-made splints in patients with the first carpometacarpal joint osteoarthritis

2012 ◽  
Vol 37 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Monireh A Bani ◽  
Mokhtar Arazpour ◽  
Reza V Kashani ◽  
Mohammad E Mousavi ◽  
Maryam Maleki ◽  
...  
Keyword(s):  
Grip Strength ◽  
Hand Function ◽  
Joint Stiffness ◽  
Strength Loss ◽  
Repeated Measure ◽  
Pinch Strength ◽  
Carpometacarpal Joint ◽  
Custom Made ◽  
First Carpometacarpal Joint ◽  
Quasi Experimental

Background: Pain, reduced grip strength, loss of range of motion, and joint stiffness, leading to impaired hand function, and difficulty with daily activities are documented symptoms of first carpometacarpal joint osteoarthritis. Splinting is a common type of conservative treatment for this injury. Objectives: The aim of this study was to evaluate the effect of custom-made thumb splints on pain, function, grip strength, and key pinch in patients with first carpometacarpal joint osteoarthritis. Study Design: Quasi experimental. Methods: Patients with first carpometacarpal grade I and II osteoarthritis (n = 18) participated in a repeated measure study. The patients all wore custom-made thumb splints. All parameters were measured at baseline, and also after 30, 60, and 90 days from initial supply. A visual analogue scale, along with a disability of the arm, shoulder, and hand questionnaire, a dynamometer and pinch gauge were used to assess pain, function, grip strength, and pinch, respectively. Results: After 60 days of splint usage, grip strength was improved. However, a reduction in pain was demonstrated after only 30 days and this continued to improve with time. Function and pinch strength also increased significantly and continued to do so during the study period when compared to baseline. Conclusions: The use of a custom-made splint for patients with osteoarthritis of the first carpometacarpal joint produced decreased pain and increased grip strength, pinch strength, and hand function. Clinical relevance Custom-made splints may be recommended for the treatment of first carpometacarpal joint osteoarthritis.

A custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization: An orthosis that promotes function and improvement in patients with the first carpometacarpal joint osteoarthritis

2013 ◽  
Vol 38 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Monireh Ahmadi Bani ◽  
Mokhtar Arazpour ◽  
Stephen William Hutchins ◽  
Fereydoun Layeghi ◽  
Mahmood Bahramizadeh ◽  
...  
Keyword(s):  
Grip Strength ◽  
Clinical Relevance ◽  
Hand Function ◽  
Pinch Strength ◽  
Conservative Approach ◽  
Carpometacarpal Joint ◽  
Custom Made ◽  
First Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Improved Function

Background and aim: Patients with mild to moderate first carpometacarpal joint osteoarthritis report pain, a reduction in pinch and grip strength and hand function. The purpose of this study was to analyze the effect of a custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization on pain, function, grip strength, and key pinch in these patients. Technique: A total of 11 volunteer patients participated in this study. All the above-mentioned parameters were evaluated at baseline and also 30, 60, and 90 days after using the splint. Discussion: A decrease in pain was observed after 30 days, and this continued to improve during treatment with the splint. After 90 days of using the splint, grip strength was improved. Function and pinch strength also increased significantly and was maintained during the study period compared to baseline. Clinical relevance A custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization may be a suitable conservative approach for the treatment of first carpometacarpal joint osteoarthritis.

scholarly journals Metacarpophalangeal Arthrodesis with Resection-suspension Arthroplasty in First Carpometacarpal Osteoarthritis

2020 ◽  
Vol 48 (01) ◽  
pp. 027-030
Author(s):  
Jose A. Oteo-Maldonado ◽  
Patricia Merino-Carretero
Keyword(s):  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Wilcoxon Test ◽  
Carpometacarpal Joint ◽  
Medium Term ◽  
Hand Grip ◽  
First Carpometacarpal Joint ◽  
Quick Dash ◽  
Carpometacarpal Osteoarthritis

AbstractFirst carpometacarpal joint osteoarthritis (CMC-1) may develop first metacarpophalangeal joint hyperextension (MCP-1). We enrolled patients with CMC-1 osteoarthritis and MCP-1 hyperextension ≥40 degrees treated with resection-suspension arthroplasty and MCP-1 intramedullary arthrodesis with XMCP™ system. Minimum follow-up was five years. We evaluated: thumbinterphalangeal (IP) range ofmotion, key pinch, hand grip, Kapandji, VAS and Quick DASH. Wilcoxon test was uses for statistical analysis.Nineteen patients were reviewed. We found improvement in key pinch, hand grip, VAS and Quick DASH; statistical difference (p < 0.05) was observed in all of them except key pinch. IF thumb range of motion and Kapandji decreased.TMC arthrodesis with XMCP™ system associated with resection-suspension arthroplasty, as a treatment for CMC-1 osteoarthritis and MCP-1 hyperextension ≥40 degrees, achieves good functional results in the medium term.

Corrigendum

2013 ◽  
Vol 39 (1) ◽  
pp. 118-118
Keyword(s):  
Ligament Reconstruction ◽  
Hand Surgery ◽  
Joint Prosthesis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Basal Joint ◽  
Tendon Interposition

The authors would like to communicate the error published in ‘Long term outcome of trapeziectomy with ligament reconstruction/tendon interposition versus thumb basal joint prosthesis’, Vandenberghe L, Degreef I, Didden K et al., Journal of Hand Surgery (European Volume) 38E(8) pp. 839–843.

Modified total trapezial and partial trapezoidal excision and ligament reconstruction tendon interposition reduces symptoms in isolated scaphotrapezial-trapezoid arthritis of the wrist

2012 ◽  
Vol 37 (7) ◽  
pp. 637-641 ◽  
Author(s):  
J. Andrachuk ◽  
S. S. Yang
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Ligament Reconstruction ◽  
Pinch Strength ◽  
Wrist Flexion ◽  
Pain Scores ◽  
Excision Arthroplasty ◽  
Tendon Interposition

Trapezial excision arthroplasty with ligament reconstruction and tendon interposition (LRTI) modified to include proximal trapezoid excision was performed on 12 wrists in 10 patients with symptomatic, isolated scaphotrapezial-trapezoid (STT) arthritis. Wrist range of motion, lateral pinch and grip strength, and analog pain scores were measured pre- and post-operatively. Mean follow-up was 18 (11–42) months. Post-operatively, reported pain scores uniformly decreased ( p < 0.0001). Mean range of wrist flexion increased from 48 to 53° ( p < 0.05) and extension from 51 to 55° ( p < 0.05). There was also an overall increase in mean grip strength from 15.6 to 19.2 kg and pinch strength from 3.5 to 4.3 kg. Modified Mayo Wrist Scores were excellent in six cases, good in three, and fair in one. Our results suggest that modified total trapezial, partial trapezoidal excision and LRTI could be an effective surgical alternative in cases of isolated STT arthritis.

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