gms | German Medical Science

59. Kongress der Deutschen Gesellschaft für Handchirurgie

Deutsche Gesellschaft für Handchirurgie

11. - 13.10.2018, Mannheim

Total endoprosthesis vs. Lundborg’s resection arthroplasty for the treatment of trapeziometacarpal joint arthritis

Meeting Abstract

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  • corresponding author presenting/speaker Holger Erne - Klinik für Plastische Chirurgie und Handchirurgie, München, Germany

Deutsche Gesellschaft für Handchirurgie. 59. Kongress der Deutschen Gesellschaft für Handchirurgie. Mannheim, 11.-13.10.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc18dgh031

doi: 10.3205/18dgh031, urn:nbn:de:0183-18dgh0316

Veröffentlicht: 10. Oktober 2018

© 2018 Erne.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: There exist various operative approaches for the treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundsborg's resection arthroplasty with implantation of a total endoprosthesis.

Method: In this two-center study we retrospectively analyzed 71 patients with symptomatic osteoarthritis of the carpometacarpal (CMC) I joint stage III according to the Eaton-Littler classification. 32 patients underwent a Lundsborg's resection arthroplasty (RA-group) and 39 patients received a total endoprosthesis of the CMC I joint (TEP-group). Both groups were comparable regarding clinical and demographic data. We evaluated patient records regarding operative time, DASH-score, postoperative time until resolution of symptoms, pain level, pinch force, as well as satisfaction with the treatment.

Results: Both groups had similar mean length of follow-up of 42 months for the TEP-group and 36 months for the RA-group. The final DASH score was significantly better in the TEP-group with a mean of 10.1 compared to 21.5 for the RA-group (p<0.05). Also the time interval from surgery till absence of any pain (mean; 1.5 vs. 5.9 months) and the time of inability to work (mean; 6 vs. 21 weeks) were significantly shorter for the TEP-group compared to the RA-group(p< 0.05). The pinch force, pain intensity and the satisfaction with the treatment at follow-up were comparable for both groups (p >0.05). The duration of the operation was significantly shorter in the RA-group with a mean of 31 min compared to the TEP-group with a mean of 65 min (p<0.05).

Conclusion: Both techniques resulted in improved function of the operated hand and a clear reduction of symptoms. However, the implantation of a total endoprosthesis of the CMC I joint seems to have advantages given a significantly better DASH score and a significantly shorter time until resolution of symptoms when compared to Lundsborg's resection arthroplasty .