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49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

13.09. - 15.09.2018, Bochum

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

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  • presenting/speaker Holger Erne - Klinikum rechts der Isar

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Bochum, 13.-15.09.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc073

doi: 10.3205/18dgpraec073, urn:nbn:de:0183-18dgpraec0736

Published: September 20, 2018

© 2018 Erne.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

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 .