Resection arthroplasty versus dual mobility prosthesis in the treatment of trapeziometacarpal joint osteoarthritis: A 3 year non-randomized prospective study.

Autor: Falkner F; Department of Hand and Plastic Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.; Department of Hand and Plastic Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Tümkaya AM; Department of Hand and Plastic Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.; Department of Hand and Plastic Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Thomas B; Department of Hand and Plastic Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.; Department of Hand and Plastic Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Böcker A; Department of Hand and Plastic Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.; Department of Hand and Plastic Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Aman M; Department of Hand and Plastic Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.; Department of Hand and Plastic Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Bickert B; Department of Hand and Plastic Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.; Department of Hand and Plastic Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Harhaus L; Department of Hand and Plastic Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.; Department of Hand and Plastic Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Panzram B; Department of Orthopaedics, University of Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Jazyk: angličtina
Zdroj: Journal of orthopaedics [J Orthop] 2024 Jun 10; Vol. 57, pp. 72-78. Date of Electronic Publication: 2024 Jun 10 (Print Publication: 2024).
DOI: 10.1016/j.jor.2024.06.005
Abstrakt: Purpose: Resection arthroplasty (RA) is still the most common surgical intervention for the treatment of symptomatic trapeziometacarpal (TMC) joint osteoarthritis. The implantation of a dual mobility prosthesis may represent a joint function preserving alternative. The aim of the presented study is to prospectively compare the outcomes of RA with dual mobility prosthesis.
Methods: In this 2-center non-randomized prospective study, we compared results of RA (n = 22) with implantation of a dual mobility prosthesis (n = 49) (Touch®) at a minimum of 3-year follow-up. The patients underwent preoperative assessments and postoperative follow-up at 6 weeks, 3, 6, 12, 24, and 36 months. Comparisons were conducted, covering pain assessment via the visual analogue scale (VAS), thumb range of motion (ROM), pinch and grip strength, as well as functional scores and radiological examinations.
Results: The time intervals from surgery until absence of pain on the VAS (3 months: 3 vs 1, p = 0.0001), recovery of ROM in radial (3 months: 33° vs 42°, p = 0.0001), and palmar abduction (3 months: 33° vs 48°, p = 0.0001), were significantly longer for the RA group compared with the prosthesis group. At 3-year follow-up there was no significant difference in absence of pain, ROM and grip strength between both groups. Key pinch strength was significantly weaker in the RA group compared to prosthesis group at 3 months (2.6 kg vs 4.6 kg, p = 0.001), to 3-year follow-up (3.1 kg vs 5.7 kg, p = 0.0001). The final mean DASH (15.5 vs 13.2, p = 0.01) and MHQ scores (78 vs 82, p = 0.01) were significantly better in the prosthesis group.
Conclusion: Both techniques show high patient satisfaction in mid-term follow-up. Dual mobility TMC joint arthroplasty seems to be associated with a superior pinch strength and shorter time of recovery as compared to patients after RA.
Competing Interests: Two authors declare a conflict of interest. BP received payment for a scientific lecture and a surgical workshop regarding the Touch prosthesis by Medartis. LH received a research grand independandly from this study by KeriMedical. All other authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. During the preparation of this work none of the authors used generative AI or AI-assisted technology in the writing process.
(© 2024 The Authors. Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.)
Databáze: MEDLINE
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