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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2022; 50(01): e12-e18
DOI: 10.1055/s-0042-1743512
Original Article | Artículo Original

Arthroscopic Hemitrapezectomy and Suspension with Mini TightRope for the Treatment of Rhizarthrosis: Outcome in patients in stages Eaton-Littler 2 to 3

Article in several languages: English | español

Authors

  • René Jorquera 

    1   IWAS Faculty, IWC, Chile
    2   Department of Traumatology and Orthopedics, Facultad de Medicina, Universidad Andrés Bello, Santiago de Chile, Chile
    3   Hand – Microsurgery and Arthroscopy Team, Departament of Traumatology and Orthopedics, Clínica Indisa, Santiago de Chile, Chile

  • Pablo Orellana 

    3   Hand – Microsurgery and Arthroscopy Team, Departament of Traumatology and Orthopedics, Clínica Indisa, Santiago de Chile, Chile

  • Francisco Melibosky 

    3   Hand – Microsurgery and Arthroscopy Team, Departament of Traumatology and Orthopedics, Clínica Indisa, Santiago de Chile, Chile

  • Eduardo Paz

    4   Clínica Indisa, IWAS, IWC INDISA, Chile

  • Rodrigo Liendo 

    5   Department of Traumatology and Orthopedics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile

  • Camila Azócar 

    3   Hand – Microsurgery and Arthroscopy Team, Departament of Traumatology and Orthopedics, Clínica Indisa, Santiago de Chile, Chile
    6   Department of Traumatology, Facultad de Medicina, Universidad de Chile, Chile
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Abstract

Introduction Rhizarthrosis is a common cause of pain and impaired function of the hand. Most patients present an excellent response to the conservative treatment, although a small percentage requires a surgical procedure due to the persistence of symptoms. Different surgical procedures have been described; however, there is still no consensus in the literature regarding the superiority of one technique over the others.

Objective To evaluate the clinical and radiological results of patients with a diagnosis of rhizarthrosis in stages 2 to 3 of the Eaton-Littler classification, submitted to arthroscopic hemitrapezectomy and suspension with Mini TightRope (Arthrex, Naples, FL, US).

Materials and methods We conducted a retrospective evaluation of the clinical and radiological results of patients operated on through the technique proposed in Clínica INDISA, in Santiago, Chile, between 2017 and 2019. The pre- and postsurgical assessments were performed using the visual analog scale (VAS) for pain, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the Kapandji score. The state of the articular cartilage was also evaluated intraoperatively according to the Badia classification.

Results A total of 12 patients (3 men and 9 women) met the inclusion criteria. Their mean age was 56 years, the mean duration of the follow-up was of 21 months. There were 7 patients in stage 2 and 5 in stage 3 according to the Eaton-Littler classification. Intraoperatively, there were 6 patients in stage II and 6 in stage III of the Badia classification. The mean preoperative score on the Kapandji index was of 3.6, and the mean postoperative score was of 9. The mean preoperative score on the VAS was of 8.8, and the mean postoperative score was of 1.2. The mean preoperative score on the DASH was of 33.3, and the mean postoperative score was of 4.7.

Conclusion Arthroscopic and suspension hemitrapezectomy with Mini TightRope for the treatment of stage 2-3 rhizarthrosis is a minimally-invasive, reproducible technique, effective in reducing pain and improving function, with sustained effects on the short and middle terms (6 to 36 months).

Keywords

rhizarthrosis - arthroscopy - basilar thumb arthritis - Level of evidence: IV

Informed Consent

The person in Figure 1 is one of the authors of this article. Informed consent was obtained.


Nivel de evidencia: IV




Publication History

Received: 17 May 2021

Accepted: 18 November 2021

Article published online:
23 June 2022

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