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Handchir Mikrochir Plast Chir 2022; 54(03): 244-252
DOI: 10.1055/a-1808-7096
Übersichtsarbeit

Our Treatment Strategy for CMC-1 Osteoarthritis

Unser Behandlungsschema bei Daumensattelgelenksarthrose
Irisa Myncke
1   AZ Monica Hospital, Florent Pauwelslei 1, 2100 Antwerp, Belgium
,
Mathias Vanhees
1   AZ Monica Hospital, Florent Pauwelslei 1, 2100 Antwerp, Belgium
2   Antwerp University Hospital, Drie Eikenstraat 955, 2650 Edegem, Belgium
,
Frederik Verstreken
1   AZ Monica Hospital, Florent Pauwelslei 1, 2100 Antwerp, Belgium
2   Antwerp University Hospital, Drie Eikenstraat 955, 2650 Edegem, Belgium
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Abstract

Osteoarthritis of the carpometacarpal joint of the thumb ( CMC-1) is a common problem and many patients will seek medical attention and may eventually need surgical treatment. As no treatment option has shown consistent superiority, a variety of surgical procedures have been proposed. In this review paper we present our algorithm for the approach of symptomatic CMC-1 osteoarthritis, supported by scientific evidence and our personal experience. It is primarily based on patient demands, status of CMC-1 disease and associated problems around the thumb. The selection of a successful surgical treatment plan with restoration of a pain free and fully functional thumb is the goal. We’ll outline the pro’s and con’s of the surgical procedures and although trapeziectomy has long been the gold standard, the advent of reliable total joint arthroplasties with good short and long-term outcome reports has changed our treatment protocol completely.

Zusammenfassung

Die Arthrose des Daumensattelgelenkes ist eine häufige Erkrankung, und viele Betroffene bedürfen einer Behandlung, oft einer chirurgischen. Da sich bisher keine der Behandlungsmethoden den anderen dauerhaft überlegen zeigte, gibt es eine Vielzahl verschiedener chirurgischer Verfahren. In dieser Übersichtsarbeit stellen wir unseren auf persönlicher Erfahrung und durch wissenschaftliche Erkenntnisse untermauerten Behandlungsalgorithmus für die Daumensattelgelenksarthrose vor. Er orientiert sich in erster Linie an den Bedürfnissen der Patienten, dem Grad der Arthrose und zusätzlich vorhandenen Problemen, auch über den Daumen hinaus; Ziel ist es die chirurgische Behandlung auszuwählen, die zu einem schmerzfreien, voll funktionstüchtigen Daumen führt. Vor- und Nachteile der verschiedenen Verfahren werden vor dem Hintergrund diskutiert, dass die Resektionsarthroplastik lange auch unser Goldstandard war, Fortschritte beim Gelenkersatz des Sattelgelenkes mit guten Früh-, aber auch Langzeitergebnissen uns jedoch zu einem kompletten Umdenken bzgl. unserer Behandlungsstrategie veranlassten.

Key words

CMC-1 osteoarthritis - CMC-1 arthroplasty - trapeziectomy

Schlüsselwörter

Daumensattelgelenksarthrose - Daumensattelgelenksprothese - Trapezektomie


Publikationsverlauf

Eingereicht: 08. März 2022

Angenommen: 08. März 2022

Artikel online veröffentlicht:
01. Juni 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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