Proximal interphalangeal surface replacement in patients with severe longitudinal joint axis deviation.

We compared the 2 year outcomes after proximal interphalangeal joint surface replacement in 68 joints with severe (>15°) preoperative longitudinal axis deviation and 50 joints without (<5°) preoperative deviation. Patients in both groups had a mean preoperative brief Michigan Hand Outcomes Questionnaire score of 47 and had similar 2 year scores of 72 (95% CI 68-77) (severe deviation) and 70 (95% CI 65-76) (no deviation). Pain, proximal interphalangeal joint range of motion, grip strength and complications did not differ between the groups at 2 years.

My Best and My Worst Operations in Rheumatoid Arthritis.

Patients with rheumatoid arthritis often undergo multiple surgical interventions throughout their lives, underscoring the importance of collaboration between surgeons and rheumatologists to stay abreast of medical advancements and ensure comprehensive patient care. The author aims to share insights into approaches and procedures that have proven effective overtime, while acknowledging those with less predictable outcomes. These insights are gleaned from the collective wisdom of hand surgery luminaries whose technical prowess and compassionate care have shaped our practice.

Which would you choose again? Comparison of trapeziometacarpal implant versus resection arthroplasty in the same patient.

We invited 14 women who had undergone implant arthroplasty in one thumb and resection-suspension-interposition arthroplasty (RSIA) in the other to a follow-up visit at a median time of 2.2 and 6.2 years after implant and RSIA, respectively.

Proximal interphalangeal joint arthroplasty: current trends and evidence-based practice.

Arthroplasty of the proximal interphalangeal joint (PIPJ) has evolved since its inception over 60 years ago. This review examines the indications for surgery, highlights the differences in current arthroplasty designs, variances in surgical techniques, clinical controversies, current implant outcomes data and salvage options for the failed implant. Overall, PIPJ implant arthroplasty is a good and reliable option for symptomatic PIPJ degenerative, post-traumatic or inflammatory arthritis given the proper clinical setting.

Basal thumb arthritis surgery: complications and its management.

The management of complications after surgery for basal thumb arthritis is sometimes challenging, and there are no clear recommendations on how to evaluate and manage patients with residual symptoms. The aim of the present article was to review the most common complications after surgery for basal thumb arthritis, with an emphasis on resection arthroplasty, joint replacement and joint fusion. In addition, possible management strategies for the different types of complications will be highlighted.

Management of the capsule in trapeziometacarpal joint implant arthroplasty: resection versus repair.

We compared the effects of capsule resection versus capsule suturing in patients treated with a dual-mobility trapeziometacarpal joint prosthesis. We included 131 patients with capsular resection and 57 patients with repair. The mean scores for pain and the brief Michigan Hand Outcomes Questionnaire were similar between the groups preoperatively and at 6 weeks and 1 year postoperatively.

Diagnostic and treatment recommendations for recurrent or persistent symptoms after trapeziectomy: a Delphi study.

The aim of this Delphi study was to provide a diagnostic and treatment algorithm for patients with persistent or recurrent symptoms after trapeziometacarpal joint resection arthroplasty. Three Delphi rounds were conducted in which surveys were sent to 182 experienced hand surgeons worldwide. Responses were received from 140 participants.

Revisions after Trapeziometacarpal Joint Resection Arthroplasty: A Systematic Literature Review.

Background: The aim of this systematic literature review was to describe current indications and interventions for revisions after trapeziometacarpal joint (TMJ) resection arthroplasty.

Methods: The literature search was conducted by an experienced librarian in the MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus databases. The authors included all articles that investigated any TMJ arthroplasty procedure in which the trapezium was completely resected and if any subsequent revision procedure including joint-related and soft-tissue operations was mentioned.

Are patients satisfied with online video consultations for assessing their hand disorder?

Objectives: The aim was to evaluate patient satisfaction with online video consultations in assessing hand disorder.

Material And Methods: This prospective study included patients who attended a video consultation, either as an initial meeting to assess the need for further evaluation or treatment or as an early postoperative follow-up consultation. After the consultation, they completed a satisfaction questionnaire.

Does distal interphalangeal joint arthrodesis affect proximal interphalangeal joint arthroplasty outcomes in the same finger?

The purpose of this study was to analyse the 1-year outcomes after combining a surface replacing proximal interphalangeal joint arthroplasty and a distal interphalangeal screw arthrodesis and to compare the combined surgery with proximal interphalangeal joint arthroplasty alone. To obtain two groups with similar baseline data from our prospective registry, propensity score matching was used to match 23 fingers with the combined operations with 115 fingers with proximal interphalangeal joint arthroplasty alone. One year after surgery, the mean ranges of motion were 60° (95% CI: 53° to 67°) in the combined group and 63° (95% CI: 60° to 66°) in the control group and did not differ significantly.

Short-term recovery after implant versus resection arthroplasty in trapeziometacarpal joint osteoarthritis.

We compared the short-term recovery of patients treated with trapeziometacarpal joint (TMJ) implant arthroplasty versus resection-suspension-interposition (RSI) arthroplasty. Implant patients ( = 147) had a better 3-month postoperative brief Michigan Hand Outcomes Questionnaire (MHQ) score (mean 82) compared to RSI patients ( = 127), who had a mean score of 69. Key pinch strength at 3 months was also higher in the implant group compared to the RSI group (6.

Preoperative Thresholds of Pain and Function to Achieve a Minimal Important Change and Patient Acceptable Symptom State After Proximal Interphalangeal Joint Arthroplasty.

Purpose: There is ongoing discussion about the level of symptoms patients with proximal interphalangeal (PIP) joint osteoarthritis should have to undergo surgery. The aims of our study were to determine the minimal important change (MIC) and patient acceptable symptom state (PASS) for PIP joint range of motion (ROM), and define clinically relevant thresholds of preoperative pain and function at which patients have the greatest chance to achieve a MIC and PASS in these outcomes 1 year after PIP arthroplasty.

Methods: We analyzed registry data that included patients with PIP joint osteoarthritis who underwent an arthroplasty for this condition and had a 1-year follow-up.

Three-Dimensionally Planned and Printed Patient-Tailored Plates for Corrective Osteotomies of the Distal Radius and Forearm.

Purpose: We evaluated the 1-year postoperative clinical and patient-reported outcomes in patients who had a 3-dimensional planned corrective osteotomy of their distal radius, radial shaft, or ulnar shaft using a printed, anatomical, patient-tailored plate to determine the feasibility and effectiveness of this methodology.

Methods: Simulations in computer-assisted preoperative planning of corrective osteotomies resulted in 3-dimensionally printed surgical guides, surgical models, and anatomically customized plates for application at the distal radius and forearm. Patients with malunions of the distal radius or forearm who underwent fixation with the custom-made plates were documented in our registry.

Intraoperative Load Tolerance of the Thumb Carpometacarpal Joint After Resection-Suspension-Interposition Arthroplasty.

Purpose: The objective was to measure the intraoperative load tolerance of the thumb carpometacarpal (CMC) joint after trapeziectomy, tendon suspension, and interposition.

Methods: In this single-center prospective study, preoperative pinch grip, thumb mobility, and hypermobility of the thumb CMC joint were determined by 2 hand surgeons. Patients completed the brief Michigan Hand Outcomes Questionnaire.

The impact of COVID-19 pandemic on hand surgery: a FESSH perspective.

COVID-19 has affected us all. The following collection of short essays highlights various aspects of the pandemic and how it has impacted hand surgery and lessons learned, from the perspective of the Federation of European Societies for Surgery of the Hand (FESSH) Executive Committee members. A range of topics were individually chosen by each of the five committee members and presented.

Cost-Utility Analysis of Thumb Carpometacarpal Resection Arthroplasty: A Health Economic Study Using Real-World Data.

Purpose: Knowledge about the costs and benefits of hand surgical interventions is important for surgeons, payers, and policy makers. Little is known about the cost-effectiveness of surgery for thumb carpometacarpal osteoarthritis. The objective of this study was to examine patients' quality of life and economic costs, with focus on the cost-utility ratio 1 year after surgery for thumb carpometacarpal osteoarthritis compared with that for continued nonsurgical management.

Bioabsorbable poly-L/D-lactide (96/4) scaffold arthroplasty as a salvage procedure in the metacarpophalangeal joint.

We report the case of a 69-year-old female patient, who developed an impressive foreign body reaction around broken metacarpophalangeal silicone implants, including serious axillary lymphadenopathy 3 years after surgery. Possible revision arthroplasties were evaluated but, due to poor bone stock, no regular implants could be used. Instead, a double RegJoint™ (Scaffdex Oy, Finland), a bioabsorbable poly-L/D-lactide implant, was used for each of the 4 metacarpophalangeal joints.

Outcomes and recommendations for revision of thumb carpometacarpal resection arthroplasty.

This study investigated revision surgery for the thumb after failed trapeziectomy with ligament reconstruction and tendon interposition and defined a revision concept. Twenty-four patients with 25 affected thumbs were examined at a mean of 5.5 years after their last revision operation.

Arthroplasty in the hand: what works and what doesn't?

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.