Abstract
Ostoearthritis of the trapeziometacarpal (TMC) joint, the key joint in thumb opposition, is one of the most common diseases involving the hand, especially among middle-aged and elderly women, and can seriously impair overall hand function.
Material and Methods: The purpose of this study was to analyze our experience in the treatment of trapezio-metacarpal (TMC) osteoarthritis with a cemented surface replacement arthroplasty (SR Avantis prosthesis). We did a retrospective study of 34 patients with 43 hands operated on with this technique, with a follow-up evaluation of 36 months. We analyzed the preoperative stage, the postoperative clinical results, measured the radiographic changes found at the end of the study. For outcome, Quick-DASH (Disabilies of the Arm, Shoulder and Hand Score) scores was used.
A Jamar dynamometer was used to assess the grip and pinch strengths which showed a 63% of recovering of the grip strength. Overall survival after a mean follow up of 36 months was 93%. At final follow up mean Quick DASH score was 27.4 Radiological review of the surviving joints showed subsidence of trapezial component in 4 joints and further lucencies in 3 joints. However, these patients had good hand function and grip strength. No sign of osteolysis was seen in any of the cases. We found that the radiological findings did not correlate with clinical findings. Satisfaction rate was 26 good to excellent, with 5 fair and 3 poor.
Conclusion: The three years results of the SR joint replacement are promising with satisfactory functional outcome despite some radiological findings.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
