AI Article Synopsis
- Trapezium excision combined with ligament reconstruction and tendon interposition using acellular dermal allograft is an effective treatment for thumb carpometacarpal joint arthritis, minimizing donor-site complications.
- In a study involving 89 patients, significant reductions in pain and substantial increases in grip and pinch strength were observed post-surgery, with no foreign body reactions or infections reported.
- Overall, the technique boasts strong clinical outcomes and serves as a safer alternative to traditional autograft methods.
Article Abstract
Purpose: Trapezium excision with ligament reconstruction and tendon interposition has proved to be highly effective in the treatment of thumb carpometacarpal joint arthritis. Donor-site morbidity from autograft harvest can be avoided by using an allograft. We report the outcomes after suspension and interposition arthroplasty using an acellular dermal allograft (GraftJacket; Wright Medical Technology, Inc., Arlington, TN) for thumb carpometacarpal arthritis.
Methods: Eighty-nine patients (100 thumbs) had surgery for thumb carpometacarpal arthritis using acellular dermal allograft instead of flexor carpi radialis tendon autograft. Evaluation of the results was performed for 82 thumbs with adequate data. Each patient was followed up for a minimum of 12 months (average, 30 months). Pain levels, grip strength, key pinch strength, range of motion, and radiographic measurements were performed.
Results: Between the preoperative and final follow-up measurements, patient pain levels (on a visual analog scale) were significantly reduced, from 6.2 to 0.7. Comparisons between preoperative and postoperative strength measurements showed an average 16% increase in grip strength and 19% increase in key pinch strength. No differences were found for radial abduction and palmar abduction data, respectively. Comparison with the preoperative x-rays showed the thumb metacarpal had subsided 31% of the arthroplasty space. No patient experienced a foreign body reaction or suffered an infection in our series.
Conclusions: Trapeziectomy with suspension and interposition arthroplasty using an acellular dermal allograft is highly effective for the treatment of thumb carpometacarpal arthritis. This procedure provides a safe and effective alternative to autograft for both ligament reconstruction and tendon interposition and eliminates the potential morbidity of autograft harvest.
Type Of Study/level Of Evidence: Therapeutic IV.
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| http://dx.doi.org/10.1016/j.jhsa.2009.03.001 | DOI Listing |
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