gms | German Medical Science

Objectives/Interrogation: Distal resection of the scaphoid is known as an arthroscopic treatment of isolated STT osteoarthritis as an alternative treatment to open procedures, like resection arthroplasties or STT Fusion. Due to the insertion of carpal ligaments on the distal scaphoid, which are promoting mediocarpal stability, we prefer the arthroscopic resection distally on the trapezoid and the trapezium (TT-RSA) without resection of the scaphoid. We are presenting the follow up of our modified procedure (n=20) with the objectives on pain reduction, functional scores and patent satisfaction.

Methods: N=24 arthroscopic TT-RSAs were included in the study after exclusion of 3 patients with the need of secondary procedures and exclusion of resection arthroplasties with simultaneous surgeries on the carpus or the wrist. Average follow up time was 16,7 months. Patent age was 58,8 years on average. We evaluated qDASH and pain score VAS (0-10) in rest and on exertion preoperatively, after 6 months and on follow up. Also grip strength, key and pulp pinch and patient satisfaction was evaluated.

Results and Conclusions: QDASH in the ongoing study is 51,2 ± 18,5(SD) preoperatively, 32,4 ± 22,3 six months postop and 12,7 ± 15,9 on follow up. Resting pain is reduced from 4,9 ± 3,0 VAS preoperatively to 1,2 ± 2,2 on follow up. Pain on exertion is reported with 8,0 ± 2,1 preoperatively and 3,3 ± 2,7 on follow up. Patients are largely pleased with the procedure and recommend it. Grip strength was 80% of the contralateral side, pulp and key pinch 90,5% and 95,2% respectively.

Arthroscopic resection arthroplasty of the trapezoid and the trapezium (TT-RSA) can be recommended as a minimal invasive procedure and shows a major pain reduction for isolated STT osteoarthritis, if a preexisting mediocarpal instability is ruled out as the leading cause for the STT osteoarthritis.