gms | German Medical Science

Objectives/Interrogation: The thumb carpometacarpal joint (CMCJ) osteoarthritis (OA) is a common pathology with controversial treatment options. Arthroscopic thumb CMCJ arthrodesis for CMCJ OA had never been reported. The aim of our study is to prospectively evaluate the effectiveness of arthroscopic arthrodesis for the treatment of Eaton stage III thumb CMCJ OA.

Methods: This study prospectively recruited all cases with Eaton III thumb CMCJ OA treated with arthroscopic arthrodesis from January 2015 to June 2017. The patients were evaluated objectively with grip strength, pinch strength, range of motion and Kapandji score. Subjective evaluation include Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the visual analog scores (VAS) for pain. All cases were assessed before the surgery and at 3 months, 6 months and 12 months after surgery. Radiographs were reviewed.

Results and Conclusions: There were total 11 cases. The average age was 62.2 with M:F = 2:9. The average follow-up time was 26.3 months. The pre-treatment pain score (VAS) was average 6.4. There was improvement of pain score at post-op 3 months (VAS 3.1, p<0.001), 6 months (VAS 1.2, p<0.001) and 12 months (VAS 0.2, p<0.001). There was improvement of grip strength and pinch strength at 12 months (p<0.001). The Dash score improved at 6 months (p=0.003) and 12 months (p<0.001). There was no significant change in the range of motion of the thumb and the Kapandji score. There was no major complication. There was one case of pseudoarthrosis (Figure 1 [Fig. 1]).

In conclusion, this prospective study is the very first report of thumb CMCJ arthroscopic arthrodesis for stage III thumb CMCJ OA. Arthroscopic arthrodesis is a feasible treatment option and provides excellent pain relief, restore thumb strength and stability, retain thumb mobility, and hence improvement in hand function.

Advantages include:

1.

allow clear assessment of joint;

2.

Small scar and minimal disturbances of joint capsule and soft tissue;

3.

Avoid tendon adhesions and

4.

better preservation of blood supply resulting in better union rate.

Future study is needed for long-term result.