gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Prospective Cohort Study of the NuGrip CMC Implant for Carpometacarpal Osteoarthritis

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  • presenting/speaker Olivier Van Not - Leids Universitair Medisch Centrum, Leiden, Netherlands
  • Marco Ritt - VUmc, Amsterdam, Netherlands
  • Freek Lötters - Hand & Pols Centrum Dordrecht, Dordrecht, Netherlands
  • Hans Pieter Van Not - Admiraal de Ruyter Ziekenhuis, Goes, Netherlands

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-115

doi: 10.3205/19ifssh1092, urn:nbn:de:0183-19ifssh10925

Published: February 6, 2020

© 2020 Van Not et al.
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

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Objectives/Interrogation: Osteoarthritis of the carpometacarpal (CMC) joint of the thumb is a common type of osteoarthritis of the hand. Complaints can consist of pain, swelling and loss of strength and movement. Multiple operative techniques have been described for the treatment of CMC-1 osteoarthritis. So far, none of these techniques have shown superior outcome. To date, implants as a treatment option for CMC 1 joint osteoarthritis still are a matter of great debate. We investigated the outcome of the hemiarthroplasty Pyrocarbon implant called the NuGrip CMC Implant.

Methods: Between 2011 and 2017 we conducted a single surgeon, single center, prospective observational cohort study including 131 patients (mean age 58 years) with CMC 1 osteoarthritis who were treated with the NuGrip implant. Clinical outcome parameters were available at 12 months for 46 patients and at 24 months for 38 patients.

They consisted of the DASH score, NRS pain score, movement of the MCP and IP joint, palmar abduction, Kapandji score, key pinch force, tip pinch-index finger force and grip strength. Outcome parameters were determined preoperative, at 12 and 24 months postoperatively.

Results and Conclusions: Mean follow up time was 23.8 months. During the course of the study 63 complications were registered in 47 patients (36%), including the removal of 11 NuGrips implants (8%). Most common complication was osteophyte formation (56%) which needed surgical removal. Further details on the complications will be discussed during the presentation.

After 12 months, patients showed improvement in DASH score (40.5 to 26.7 points; P<0,001) and NRS pain score (5.7 to 2.5 points; P<0,001). A decrease was found in the total active range of motion of the MCP joint (66.3 to 59.5 degrees; P<0,05) and key pinch force (5.3 to 4.6 Newton; P<0,05).

After 24 months, patients showed improvement in DASH score (41,3 to 25,5 points; P<0,001), grip strength (21.1 to 23.7 kg; P<0,05) and NRS pain score (5.6 to 2.0 points; P<0,001). A decrease was found in total active range of motion of the MCP joint (64.6 to 52.9 degrees; P<0,05).

The NuGrip CMC Implant shows an acceptable survival rate and relatively high number of complications, although not all complications are directly related to the implant.

The NuGrip CMC Implant provides improvement in DASH score and NRS pain score after 12 and 24 months and grip strength after 24 months. A decrease was seen in key pinch force after 12 months and in active range of motion of the MCP joint after both 12 and 24 months.