Denis Ehrl1, Holger C Erne2, P Niclas Broer3, Christian Metz2, Erwin Falter2. 1. Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Hospital, 81925 Munich, Germany. Electronic address: Denis.Ehrl@klinikum-muenchen.de. 2. Department of Plastic, Aesthetic Surgery and Hand Surgery, Kreisklinik Ebersberg, Pfarrer-Guggetzer-Str. 3, 85560 Ebersberg, Germany. 3. Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Hospital, 81925 Munich, Germany.
Abstract
BACKGROUND: Pain reduction as well as preservation and improvement in range of motion remain the main aims in the treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). We performed a retrospective outcome analysis of patients with symptomatic stage II-III thumb CMC joint arthritis treated with denervation, joint lavage and capsular imbrication. METHODS: 73 patients with stage II to III OA of the thumb CMC-joint underwent the described technique. A total of 42 patients complied with follow-up assessment and were included in this study. Mean follow-up was 41.2 (range 12-81) months. RESULTS: Mean operative time was 28.4 (±6.5) minutes. The follow-up assessments showed a significant decrease in pain (preoperative Numerical Rating Scale (NRS): 7.5 - postoperative NRS: 1.1) (p < 0.0001) and a significant improvement in function of the thumb (preoperative DASH-Score: 46.8; Cooney-Wrist-Score: 35.4; Krimmer-Wrist-Score: 38.3 - postoperative DASH-Score: 18.1; Cooney-Wrist-Score: 73.7; Krimmer-Wrist-Score: 80.0) (p < 0.0001). CONCLUSION: The findings of our study indicate that the presented treatment approach could be a good alternative to more invasive surgical options in patients with stage II-III CMC OA of the thumb, without impairing more invasive surgical options like trapeziectomy or arthroplasty for the future.
BACKGROUND:Pain reduction as well as preservation and improvement in range of motion remain the main aims in the treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). We performed a retrospective outcome analysis of patients with symptomatic stage II-III thumb CMC joint arthritis treated with denervation, joint lavage and capsular imbrication. METHODS: 73 patients with stage II to III OA of the thumb CMC-joint underwent the described technique. A total of 42 patients complied with follow-up assessment and were included in this study. Mean follow-up was 41.2 (range 12-81) months. RESULTS: Mean operative time was 28.4 (±6.5) minutes. The follow-up assessments showed a significant decrease in pain (preoperative Numerical Rating Scale (NRS): 7.5 - postoperative NRS: 1.1) (p < 0.0001) and a significant improvement in function of the thumb (preoperative DASH-Score: 46.8; Cooney-Wrist-Score: 35.4; Krimmer-Wrist-Score: 38.3 - postoperative DASH-Score: 18.1; Cooney-Wrist-Score: 73.7; Krimmer-Wrist-Score: 80.0) (p < 0.0001). CONCLUSION: The findings of our study indicate that the presented treatment approach could be a good alternative to more invasive surgical options in patients with stage II-III CMC OA of the thumb, without impairing more invasive surgical options like trapeziectomy or arthroplasty for the future.