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COMPARATIVE STUDY OF SURGICAL TREATMENT OF RHIZARTHROSIS. TOTAL PROSTHESIS VS RESECTION ARTHROPLASTY



Abstract

Introduction and purpose: Rhizarthrosis of the thumb is the most common form of osteoarthritis of the hand. In some cases it courses with intense pain and severe functional limitation of the thumb or the entire hand.

The purpose of this study is to compare the results of treating rhizarthrosis with a total ARPE trapezio-metacarpal prosthesis and trapezectomy, whether or not associated with tendon interposition and ligament repair.

Materials and methods: A retrospective comparative study in which we reviewed cases of rhizarthrosis treated surgically in our hospital between 1994 and 2004. We found 75 cases, of which 28 were treated with resection arthroplasty (group A), 32 with ARPE prosthesis (group B) and 15 with bone fusion (not included in this study). The mean age was 58.85 for group A and 63.16 for group B. Mean follow-up time was 39.5 months.

We used the DASH questionnaire for the subjective clinical examination and the Jamar dynamometer for the objective examination. For radiological assessment we used the Eaton classification and Walch radiological criteria.

Results: We analysed the results using SPSS statistical software and found no significant differences between the two groups, although the subjective assessment showed better results in terms of mobility and pain remission in group B and strength in group A.

Conclusions: The aim of surgical treatment of rhizarthrosis is to achieve a stable, pain-free thumb. Several procedures are available, the success of which depends on correct indication and meticulous surgical technique.

The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief, Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos 108, 28015-Madrid, Spain