Trapeziectomy with LRTI or joint replacement for CMC1 arthritis, a randomised controlled trial.

Abstract:

:We compared an uncemented joint replacement (Elektra) with trapeziectomy (with ligament reconstruction and tendon interposition, LRTI) for the treatment of primary osteoarthritis in the first carpometacarpal joint (CMC1) in a randomised controlled trial. Forty patients were included (20 in each group) and followed for 2 years. The median age in the groups was 64 and 61, respectively, with 14 females in each. At final follow-up, there was no difference in the primary outcome measure (the quick disabilities of the arm, shoulder and hand score, QDASH), but the joint replacement group had significantly better motion and strength during the early rehabilitation period and significantly better range of thumb abduction and extension at the last follow-up. There were more complications in the joint replacement group with revision of prosthetic components in five cases, two of them due to cup loosening. Radiologically, lucency zones were seen around either cup or stem in 15 patients. Most were small, but two cases with major osteolysis resulted in revision. Shortening of the thumb ray was observed after trapeziectomy.

journal_name

J Plast Surg Hand Surg

authors

Thorkildsen RD,Røkkum M

doi

10.1080/2000656X.2019.1635490

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

361-369

issue

6

eissn

2000-656X

issn

2000-6764

journal_volume

53

pub_type

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