T Apard1, Y Saint-Cast. 1. Département de chirurgie osseuse, CHU d'Angers, 1, rue Larrey, 49033 Angers cedex, France. thomasapard@yahoo.fr
Abstract
INTRODUCTION: The surgical gold standart treatment of the thumb osteoarthritis is the trapeziectomy with tendon interposition with ligament reconstruction. The trapeziometacarpal prosthesis is insufficiently assessed in literature. METHODS: Between 1994 and 2001, 43 trapeziometacarpal prosthesis Arpe were implanted by the same surgeon for isolated trapeziometacarpal degenerative osteoarthritis. The minimum follow-up is 5 years. 33 women and 2 men , average age 59,4-years, were operated after failure of conservative treatment. 7 patients were lost sight of (9 prosthesis) and 2 deaths (2 prosthesis). 26 other patients (32 prostheses) were examined by the author with an original revision questionnaire associated to the score of DASH. RESULTS: 7 revisions were necessary: 5 for loosening, 1 for premature dismemberment and 1 for recurrent partial dislocation. The survival of the prosthesis is 85% in 5 years. In the group of 25 prosthesis still implanted, there is no radiological sign of loosening, but in some cases a development of medial ossification. The average DASH score is 27,4/100. All the patients of this group are satisfied or very satisfied. CONCLUSION: The prosthesis Arpe is an effective option in this series for the treatment of the degenerative trapeziometacarpal arthritis but its radioclinical control is necessary for the first year.
INTRODUCTION: The surgical gold standart treatment of the thumb osteoarthritis is the trapeziectomy with tendon interposition with ligament reconstruction. The trapeziometacarpal prosthesis is insufficiently assessed in literature. METHODS: Between 1994 and 2001, 43 trapeziometacarpal prosthesis Arpe were implanted by the same surgeon for isolated trapeziometacarpal degenerative osteoarthritis. The minimum follow-up is 5 years. 33 women and 2 men , average age 59,4-years, were operated after failure of conservative treatment. 7 patients were lost sight of (9 prosthesis) and 2 deaths (2 prosthesis). 26 other patients (32 prostheses) were examined by the author with an original revision questionnaire associated to the score of DASH. RESULTS: 7 revisions were necessary: 5 for loosening, 1 for premature dismemberment and 1 for recurrent partial dislocation. The survival of the prosthesis is 85% in 5 years. In the group of 25 prosthesis still implanted, there is no radiological sign of loosening, but in some cases a development of medial ossification. The average DASH score is 27,4/100. All the patients of this group are satisfied or very satisfied. CONCLUSION: The prosthesis Arpe is an effective option in this series for the treatment of the degenerative trapeziometacarpal arthritis but its radioclinical control is necessary for the first year.