Artikel
Open synovectomy with joint debridement for treating thumb carpometacarpal arthritis: a comparative evaluation of long-term postoperative results
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Autoren
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M. Tamulevičius
- Vilnius University, Medical Faculty, Vilnius, Lithuania
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M. Minderis
- Vilnius University Hospital Santariškių Klinikos, Department of Plastic and Reconstructive Surgery, Vilnius, Lithuania
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A. Pajėda
- Vilnius University Hospital Santariškių Klinikos, Department of Plastic and Reconstructive Surgery, Vilnius, Lithuania
| Veröffentlicht: | 9. November 2016 |
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Gliederung
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Background: Several studies showed that no surgical technique for treating Thumb carpometacarpal arthritis (TMC arthritis) is superior by results. Because of that experts’ attention focuses on techniques’ cost-effectiveness and simplicity. The objective of this study was to investigate if there’s a difference in TMC arthritis treatment results between widely popular surgical techniques (ligament reconstruction with tendon interposition (LRTI) and hematoma distraction (HD) and synovectomy with joint debridement (OS).
Methods: In this retrospective study we evaluated 19 patients (mean age 57±6.54) with stage II-III TMC arthritis. All patients were treated by a senior surgeon M.M. with OS. Patient perception was evaluated with a QuickDASH questionnaire, 10-point pain visual analogue scale (VAS) and subjective treatment satisfaction scores (excellent (no symptoms); very good (few mild symptoms); good (small improvement of symptoms); bad (no change). Evaluations were made after at least 12 months of treatment (mean 54.32±34.35). Results were compared with other studies with 24 months follow-up.
Results: OS significantly reduced pain for all patients, same as popular surgical techniques. A complete relief of pain was seen for about half less patients than in LRTI and HD studies. However, at longer follow-up (at least 7.5 years) a complete relief of pain is seen for the same or even higher percent of patients. There was no significant difference in VAS and QuickDASH scores between the techniques. These scores also decrease at longer follow-up. Moreover, 95% of patients reported their results as very good or excellent, same as after LRTI or HD. There were no significant complications.
Conclusions: This study shows that treatment with open synovectomy with joint debridement improves pain and functional scores, which tend to improve significantly by time, and it has very high subjective outcomes for patients with TMC arthritis. That is why it could become primary choice for treating stage II-III TMC arthritis.
