T R Friebel1,2, E T Walbeehm3, G-J Kleinrensink4, S Ray5, J M Zuidam6. 1. Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. thessa.friebel@meht.nhs.uk. 2. St. Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital, MEHT, Court Road, CM1 7ET, Chelmsford, UK. thessa.friebel@meht.nhs.uk. 3. Department of Plastic, Reconstructive and Hand Surgery, Radboud University, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands. 4. Department of Anatomy, Erasmus University, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. 5. Department of Plastic, Reconstructive and Hand Surgery, Blond McIndoe Research Foundation, Queen Victoria Hospital, Holtye Road, RH19 3DZ, East Grinstead, UK. 6. Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
Abstract
INTRODUCTION: Laxity in the trapeziometacarpal (TMC) joint is a debilitating condition usually affecting a young population. It can be treated operatively with ligament reconstruction. The purpose of this study was to determine the effectiveness of the Arthrex Mini TightRope® in reinforcing the stabilizing ligaments in an unstable TMC joint without decreasing the range of motion of the thumb. This method was compared with the "gold standard" published by Eaton and Littler in 1973. MATERIALS AND METHODS: Six fresh frozen arms from five cadavers were included. TMC joint laxity was measured on stress view radiographs as the ratio of the radial subluxation (RS) of the first metacarpal in relation to the trapezium, by the first metacarpal articular width (AW) (as described by Wolf in 2009). Measurements of the pre- and post-operative range of motion (ROM) were performed and compared. RESULTS: Both the Arthrex Mini TightRope® and the Eaton-Littler stabilization improved the stability of the TMC joint. The pre-operative laxity value (ratio RS/AW) of 0.27 was significantly (P = 0.02) improved by each of the surgical interventions (Eaton-Littler RS/AW = 0.05 and Tightrope RS/AW = 0.09). The pre- and post-operative range of motion was not significantly different by each of the surgical interventions. There were no significant differences between the two stabilizing methods regarding laxity or range of motion. CONCLUSION: The Arthrex Mini TightRope® provided a good stabilization method for the TMC joint in this anatomical model without compromising the range of motion.
INTRODUCTION: Laxity in the trapeziometacarpal (TMC) joint is a debilitating condition usually affecting a young population. It can be treated operatively with ligament reconstruction. The purpose of this study was to determine the effectiveness of the Arthrex Mini TightRope® in reinforcing the stabilizing ligaments in an unstable TMC joint without decreasing the range of motion of the thumb. This method was compared with the "gold standard" published by Eaton and Littler in 1973. MATERIALS AND METHODS: Six fresh frozen arms from five cadavers were included. TMC joint laxity was measured on stress view radiographs as the ratio of the radial subluxation (RS) of the first metacarpal in relation to the trapezium, by the first metacarpal articular width (AW) (as described by Wolf in 2009). Measurements of the pre- and post-operative range of motion (ROM) were performed and compared. RESULTS: Both the Arthrex Mini TightRope® and the Eaton-Littler stabilization improved the stability of the TMC joint. The pre-operative laxity value (ratio RS/AW) of 0.27 was significantly (P = 0.02) improved by each of the surgical interventions (Eaton-Littler RS/AW = 0.05 and Tightrope RS/AW = 0.09). The pre- and post-operative range of motion was not significantly different by each of the surgical interventions. There were no significant differences between the two stabilizing methods regarding laxity or range of motion. CONCLUSION: The Arthrex Mini TightRope® provided a good stabilization method for the TMC joint in this anatomical model without compromising the range of motion.
Authors: Alexandra Stauffer; Yvonne Schwarz; Marion Uranyi; Florian Schachinger; Werner Girsch; Rudolf Ganger; Sebastian Farr Journal: Arch Orthop Trauma Surg Date: 2019-11-06 Impact factor: 3.067