Yasunori Hattori1, Kazuteru Doi2, Brian Dormitorio2, Sotetsu Sakamoto2. 1. Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan. Electronic address: yhattori@saikyo.or.jp. 2. Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan.
Abstract
PURPOSE: To investigate the outcomes of trapeziometacarpal (TMC) joint arthrodesis for primary osteoarthritis in elderly patients in comparison with a younger cohort. METHODS: We performed a retrospective study of outcomes following TMC joint arthrodesis between patients older than 65 years (elderly group) and patients younger than 55 years (younger group). Thirty-eight hands in 29 patients were included in this study. There were 19 hands in 16 elderly patients and 19 hands in 13 younger patients with average ages of 68 and 52 years, respectively. Postoperative follow-ups were 36 and 35 months, respectively. Patient-reported upper extremity disability was assessed using the Japanese Society for Surgery of the Hand version of Disabilities of the Arm, Shoulder, and Hand (DASH). Clinical evaluation of impairment measures included measurement of key pinch strength, grip power, range of motion, and Kapandji score. RESULTS: In both groups, surgery was effective in relieving pain. The DASH score improved at the final follow-up in both groups. Improvements in the DASH score showed similar results in both groups. Preoperative key pinch strength was similar between the 2 groups. Although this improved for both groups, the younger group did have greater improvement. Grip strength also improved in both groups. The younger group had better pre- and postoperative grip strength; however, the extent of improvement was similar between the 2 groups. Postoperative range of motion and Kapandji scores were similar between the 2 groups. CONCLUSIONS: Outcomes of patients older than 65 years following TMC joint arthrodesis and those of patients younger than 55 years were similar except for improvement of key pinch strength. This procedure has a role in the surgical treatment of primary TMC joint osteoarthritis in the elderly as well as in younger patients. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PURPOSE: To investigate the outcomes of trapeziometacarpal (TMC) joint arthrodesis for primary osteoarthritis in elderly patients in comparison with a younger cohort. METHODS: We performed a retrospective study of outcomes following TMCjoint arthrodesis between patients older than 65 years (elderly group) and patients younger than 55 years (younger group). Thirty-eight hands in 29 patients were included in this study. There were 19 hands in 16 elderly patients and 19 hands in 13 younger patients with average ages of 68 and 52 years, respectively. Postoperative follow-ups were 36 and 35 months, respectively. Patient-reported upper extremity disability was assessed using the Japanese Society for Surgery of the Hand version of Disabilities of the Arm, Shoulder, and Hand (DASH). Clinical evaluation of impairment measures included measurement of key pinch strength, grip power, range of motion, and Kapandji score. RESULTS: In both groups, surgery was effective in relieving pain. The DASH score improved at the final follow-up in both groups. Improvements in the DASH score showed similar results in both groups. Preoperative key pinch strength was similar between the 2 groups. Although this improved for both groups, the younger group did have greater improvement. Grip strength also improved in both groups. The younger group had better pre- and postoperative grip strength; however, the extent of improvement was similar between the 2 groups. Postoperative range of motion and Kapandji scores were similar between the 2 groups. CONCLUSIONS: Outcomes of patients older than 65 years following TMCjoint arthrodesis and those of patients younger than 55 years were similar except for improvement of key pinch strength. This procedure has a role in the surgical treatment of primary TMCjoint osteoarthritis in the elderly as well as in younger patients. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.