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Type: Journal article
Title: Trapezial arthroplasty with silicone rubber implantation for advanced osteoarthritis of the trapeziometacarpal joint of the thumb
Author: MacDermid, J.
Roth, J.
Rampersaud, Y.
Bain, G.
Citation: Canadian Journal of Surgery, 2003; 46(2):103-110
Publisher: Canadian Medical Association
Issue Date: 2003
ISSN: 0008-428X
Statement of
Joy C. MacDermid, James H. Roth, Y. Raj Rampersaud and Gregory I. Bain
Abstract: <h4>Introduction</h4>Arthritis in the trapeziometacarpal joint of the thumb can cause swelling and loss of motion. Treatment options include arthrodesis, replacement arthroplasty and interposition arthroplasty. Our objective in this clinical study was to determine outcomes after trapezial arthroplasty with a silicone rubber implant and the relationship between self-reported and measured outcomes.<h4>Methods</h4>At the Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ont., a tertiary care centre, we reviewed a series of 26 patients with advanced osteoarthritis who underwent silicone rubber trapezial arthroplasty. The follow-up averaged 6.5 years. We assessed the outcomes subjectively, and by clinical, functional and radiographic examination.<h4>Results</h4>Although 88% of patients reported some improvement in pain and satisfaction, when quantified the improvement was less impressive: only 5.7 (on a visual analogue scale of 1-10, poor-excellent) for pain and 5.6 for satisfaction. Superior subjective results were reported by patients older than 60 years. Osteoarthritic changes had caused pronounced functional impairment in the hands of patients who underwent surgery and those who did not, so that any long-term benefit of surgery was not measurable. Patients had difficulty manipulating both small and large objects on the Jebsen's hand function test. Peri-implant and carpal radiographic lytic changes were observed in 90% of patients. Six patients (20%) required revision surgery (3 early, 3 late), including 1 with a pathologic scaphoid fracture.<h4>Conclusions</h4>Although clinical, functional and radiographic results were poor, they did not predict either satisfaction or pain improvement reported by patients, illustrating the need for a comprehensive standardized outcome evaluation to make informed decisions on the value of surgical intervention for osteoarthritis of the trapeziometacarpal joint.
Keywords: Thumb
Silicone Elastomers
Hand Strength
Range of Motion, Articular
Treatment Outcome
Retrospective Studies
Prostheses and Implants
Bone Wires
Age Factors
Aged, 80 and over
Middle Aged
Patient Satisfaction
Rights: © 2003 Canadian Medical Association
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Appears in Collections:Aurora harvest
Orthopaedics and Trauma publications

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