Article
Trapeziometacarpal and scapho-trapezoid-trapezoidal pyrocarbon “burger arthroplasty” for early peritrapezial osteoarthritis
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Authors
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Camilo Chaves
- Université Paris XI, Le Kremlin-Bicêtre, France
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Philippe Bellemère
- Institut de la main, Saint Herblain, France
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: Trapezo-metacarpal and scapho-trapezotrapezoid arthroplasty based on pyrocarbon resurfacing implants is known as "burger arthroplasty". This technique was proposed in 2014 for the treatment of early stages of symptomatic and debilitating peritrapezial osteoarthritis.
This study presents the mid-term clinical results of the initial series
Methods: This prospective monocentric study included consecutive patients who underwent a "burger arthroplasty" between 2009 and 2017. The surgical technique followed the original description. The epidemiological data of the population was analyzed. Results were evaluated according to the standardized QuickDASH and the PRWE functional scores at the time of the last follow-up. Thumb mobility, strength (pinch and grip), rest pain and maximum pain were assessed by standardized means.
Results and Conclusions: Thirteen patients were included. Ten women (77%) and three men (23%). Their average age was 60 (50-70 years). Average follow-up was 53.3 months (9-95 months). QuickDASH and PRWE scores were respectively 28.8 (2.3-72.7) and 27.8 (0-63.5) at the last follow-up. Average grip strength was 25.2 kg (15-42 kg). Average pinch strength was 5.9 kg (2.7-10 kg). Average pain at rest was 0.7 / 10 (0-3) and the average maximum pain was 4.7/10 (0-10) according to the visual analogue scale. Kapandji's thumb mobility averaged 9.9 (9-10). At the last follow-up, no displacement or instability of the implants was demonstrated either clinically or radiologically.
"Burger arthroplasty" is indicated for early peritrapezial osteoarthritis with no trapezoidal collapse or significant structural bone involvement. This is a conservative and minimally invasive technique compared to conventional trapeziectomy. It reduces pain, preserves pinch and grip strength, and improves thumb mobility.
This arthroplasty is a promising surgical technique for the treatment of early stages of peritrapezial osteoarthritis and should be find its place in the arsenal therapeutic of hand surgeons.
