Autologous Fat Injection versus Lundborg Resection Arthroplasty for the Treatment of Trapeziometacarpal Joint Osteoarthritis.

Abstract:

BACKGROUND:Various operative approaches exist for treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundborg resection arthroplasty with solely autologous fat injection. METHODS:Twenty-one patients with symptomatic osteoarthritis of the trapeziometacarpal joint (Eaton-Littler classification stages III/IV) underwent either a Lundborg resection arthroplasty (n = 12) or autologous fat injection into the trapeziometacarpal joint (n = 9). Both groups were comparable regarding demographic and clinical data. Patient records were evaluated retrospectively regarding operative time; Disabilities of the Arm, Shoulder, and Hand questionnaire score; postoperative time until resolution of symptoms; pain level; grip and pinch force; and satisfaction with the treatment. RESULTS:Both groups had similar length of follow-up of at least 12 months. The duration of the operation was significantly shorter in the fat group (13 ± 5 minutes) compared with the resection group (31 ± 5 minutes) (p < 0.05). The Disabilities of the Arm, Shoulder, and Hand questionnaire score (resection group, 21.9 ± 6.2; fat group, 24.0 ± 5.0) and the pain level at follow-up (resection group, 1.0 ± 0.7; fat group, 2.9 ± 0.8) were comparable (p > 0.05). The time until complete resolution of symptoms was significantly shorter in the fat group (1.7 ± 2.1 months) compared with the resection group (5.7 ± 3.1 months) (p < 0.05). Grip and pinch strength and overall satisfaction with the treatment were comparable (p > 0.05). CONCLUSION:Both autologous fat grafting and Lundborg resection arthroplasty resulted in improved function of the operative hand and a clear reduction of symptoms, whereas autologous fat injection seems to have advantages attributable to a shorter time until resolution of symptoms and shorter operative times. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, III.

journal_name

Plast Reconstr Surg

authors

Erne HC,Cerny MK,Ehrl D,Bauer AT,Schmauss V,Moog P,Broer PN,Loew S,Schmauss D

doi

10.1097/PRS.0000000000003913

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

119-124

issue

1

eissn

0032-1052

issn

1529-4242

pii

00006534-201801000-00025

journal_volume

141

pub_type

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