PDF icon Download PDF
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
› Author Affiliations
› Further Information
Also available ateRef
   Permissions and Reprints
Preview

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


Publication History

Received: 08 March 2022

Accepted: 08 March 2022

Article published online:
01 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Sodha S, Ring D, Zurakowski D. et al. Prevalence of osteoarthritis of the trapeziometarpal joint. J Bone Joint Surg Am 2005; 87: 2614-2618
    Search in Google Scholar
  • 2 Armstrong AL, Hunter JB, Davis TR. The Prevalance of degenerative arhtritis of the base of the thumb in post-menopausal woman. J Hand Surg Br 1994; 19: 340-341
    Search in Google Scholar
  • 3 Ghavami A, Oishi SN. Thumb trapeziometacarpal arthritis: treatment with ligament reconstruction tendon interposition arthroplasty. Plast Reconstr Surg 2006; 117: 116e-128e
    Search in Google Scholar
  • 4 Florack TM, Miller RJ, Pellegrin VD. et al. The prevalence of carpal tunnel syndrome in patients with basal joint arthritis of the thumb. J Hand Surg Am 1992; 17: 624-630
    Search in Google Scholar
  • 5 Rectenwald JP, Green DP, Dobyns JH. Symptomatic Carpal Collapse After Trapeziectomy and Partial Trapeziectomy: Report of Two Cases. J Hand Surg 2005; 30: 706-710
    Search in Google Scholar
  • 6 Paul AW, Athens CM, Patel R, Rizzo M, Rhee PC. Effect of Trapeziectomy on Carpal Stability. HAND 07/2020;
    Search in Google Scholar
  • 7 Yuan B, Moran S, Chao Tay S. et al. Trapeziectomy and Carpal Collapse. J Hand Surg 2009; 34: 219-277
    Search in Google Scholar
  • 8 Rannou F, Dimet J, Boutron I. et al. Splint for base-of-thumb osteoarthritis: a randomized trial. Ann Interne Med 2009; 150: 661-669
    Search in Google Scholar
  • 9 Ladd AL, Messana JM, Berger AJ. et al. Correlation of clinical disease severity to radiographic thumb osteoarthritis index. J Hand Surg Am 2015; 40: 474-482
    Search in Google Scholar
  • 10 Berggren M, Joost-Davidsson A, Lindstrand J. et al. Reduction in the need for operation after conservative treatment of osteoarthritis of the first carpometacarpal joint: a seven year prospective study. Scand J Plast Reconstr Surg Hand Surg 2001; 35: 415-417
    Search in Google Scholar
  • 11 Rannou F, Dimet J, Boutron I. et al. Splint for base-of-thumb osteoarthritis: a randomized trial. Ann Interne Med 2009; 150: 661-669
    Search in Google Scholar
  • 12 Villafane JH, Valdes K, Pedersini P. et al. Thumb caropmetacarpal osteoarhtritis: A musculoskeletal physiotherapy perspective. J Bodyw Mov Ther 2019; 23: 908-912
    Search in Google Scholar
  • 13 Riley N, Vella-Baldacchino M, Thurley N. et al. Injection therapy for the base of thumb osteoarthritis: A systematic review and meta-analysis. BMJ Open 2019; 9: e027507
    Search in Google Scholar
  • 14 Sodhi N, Mont MA. Survival of total hip replacements. The Lancet 2019; 393: 613
    Search in Google Scholar
  • 15 Day CD, Gelberman R, Ptael AA. et al. Basal joint osteoarthritis of the thumb: A prospective trial of steroid injection and splint. J Hand Surg Am 2004; 29: 247-251
    Search in Google Scholar
  • 16 Vermeulen GM, Slijper H, Feitz R. et al. Surgical management of primary thumb carpometacarpal osteoarthritis: A systematic review. J Hand Surg Am 2011; 36: 157-169
    Search in Google Scholar
  • 17 Vandenberghe L, Degreef I, Didden K. et al. Long term outcome of trapeziectomy with ligament reconstruction/tendon interposition versus thumb basal joint prosthesis. J Hand Surg Eur Vol 2013; 38: 839-843
    Search in Google Scholar
  • 18 Cebrian-Gomez R, Lizaur-Utrilla A, Sebastia-Forcada E. et al. Outcomes of cementless joint prosthesis versus tendon interposition for trapeziometacarpal osteoarthritis: a prospective study. J Hand Surg Eur Vol 2018; 44: 151-158
    Search in Google Scholar
  • 19 Ulrich-Vinther M, Puggaard H, Lange B. Prospective 1-year Follow-Up Study Comparing Joint Prosthesis With Tendon Interpostion Arhtroplasty in Treatment of Trapeziometacarpal Osteoarthritis. J Hand Surg Am 2008; 33: 1369-1377
    Search in Google Scholar
  • 20 Thorkildsen RD, Rokkum M. Trapeziectomy with LRTI or joint replamcent for CMC1 arthritis, a randomized controlled trial. J Plast Surg Hand Surg 2019; 53: 61-69
    Search in Google Scholar
  • 21 Bonetti MA, Rovere G, Fulchigoni C. et al. Autologus fat transplantation for the treatment of trapeziometacarpal joint osteoarthritis. Orthop Rev (Pavia) 2020; 12: 8666
    Search in Google Scholar
  • 22 Bohr S, Rennekampff HO, Pallua N. Cell-enriched Lipoaspirate Arthroplasty: A Novel Approach to First Carpometacarpal Joint Arthritis. Hand Surg Int J Devated Hand Up Limb Surg Relat Res J Asia-pac Fed Soc Surg Hand 2015; 20: 479-481
    Search in Google Scholar
  • 23 Herold C, Rennekampff H-O, Groddeck R, alert S. Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Study. Plast Reconstr Surg 2017; 140: 327-335
    Search in Google Scholar
  • 24 Haas EM, Eisele A, Arnoldi A. et al. One-year outcomes of intraarticular fat transplantation for thumb carpometacarpal joint osteoarthritis- case review of 99 joints. Plast Reconstr Surg 2020; 145: 151-159
    Search in Google Scholar
  • 25 Kapandji A, Heim FA. Lʼostéotomie de réorientation de la selle trapézienne. Chir Main 2002; 21: 124-133
    Search in Google Scholar
  • 26 Garcia-Elias Orsolini C. Relationship between thumb laxity and trapezium kinematics. Chir Main 2011; 30: 224-227
    Search in Google Scholar
  • 27 Van Royen K, Gevers M, Vanmierlo B. et al. Radiological measurement of trapezial dysplasia- variation of trapezial tilt and trapezial inclination. Hand Surg Rehabil 2020; 40: 44-50
    Search in Google Scholar
  • 28 Hobby JL, Lyall HA, Meggit BF. First metacarpal osteotomy for trapeziometacarpal osteoarthritis. J Bone Joint Surg Br 1998; 80: 508-512
    Search in Google Scholar
  • 29 Thuysbaert G, Goorens CK, Vanmierlo B. et al. Addition-substraction osteotomy with ligamentoplasty for symptomatic trapezial dyspalsia with metacarpal instability. J Hand Surg Am 2021; 46: 342.e1-342.e9
    Search in Google Scholar
  • 30 El-Mahy MM. Trapezial Osteotomy for the treatment of trapezial dysplasia. Ann Plast Surg 2013; 71: 485-488
    Search in Google Scholar
  • 31 Parker WL, Linscheid RL, Amadio PC. Long-term outcomes of first metacarpal extension osteotomy in the treatment fo carpal-metacarpal osteoarthritis. J Hand Surg Am 2008; 33: 1737-1743
    Search in Google Scholar
  • 32 Bachoura A, Yakish EJ, Lubahn JD. Survival and long-term outcomes of Thumb metacarpal extension osteotomy for symptomatic carpometacarpal laxity and Early Basal joint arhtritis. J Hand Surg Am 2018; 43: 772.e1-772.e7
    Search in Google Scholar
  • 33 Cheema T, Salas C, Morrell N. et al. Opening wedge trapezial osteotomy and possible treatment for early trapeziometacarpal osteoarthritis: a biomechanical investigation of radial subluxation, contact area and contact pressure. J Hand Surg Am 2012; 37: 699-705
    Search in Google Scholar
  • 34 Goubau JF, Ackerman P, Kerckhove D. et al. Addition-substraction osteotomy without ligamentoplasty for symptomatic trapezial dyspalsai with metacarpal instabiliy. J Hand Surg Eur Vol 2012; 37: 138-144
    Search in Google Scholar
  • 35 Rizzo M, Moran SL, Shin AY. Long-term outcomes of trapeziometacarpal arhtrodesis in the management of trapeziometacarpal arhtritis. J Hand Surg Am 2009; 34: 20-26
    Search in Google Scholar
  • 36 Hartigan BJ, Stern PJ, Kiefhaber TR. Thumb carpometacarpal osteoarthritis: arthrodesis compared with ligament reconstruction and tendon interposition. J Bone Joint Surg Am 2001; 83: 1470-1478
    Search in Google Scholar
  • 37 Pillukat T, Mühldorfer-Fodor M, Fuhrman R. et al. Arthrodesis of the trapeziometacarpal joint. Oper Orthop Traumatol 2917 29: 395-408
  • 38 Saheb RLC, Vaz BAS, Soeira TP. et al. Surgical treatment for rhizarthrosis: a systematic review of the last 10 years. Acta Ortop Bras 2022; 30: e246704
    Search in Google Scholar
  • 39 Borgers A, Verstreken A, Vanhees M. et al. Primary endoprosthetic replacement of the arthritic CMC-1 joint. Oper OrthopTraumatol 2020; 33: 228-244
    Search in Google Scholar
  • 40 Robles-Molina MK, Lopez-Caba F, Gomez-Sanches RC. et al. Trapziectomy with ligament reconstruction and tendon interposition versus a Trapeziometacarpal prosthesis for the Treatment of thumb basla joint osteoarthritis. Orthopedics 2017; 40: e681-e686
    Search in Google Scholar
  • 41 Toffoli A, Teissier J.. MAÏA Trapzeiometacarpal joint arthroplasty: clinical and radiological outcomes of 80 patients with more than 6 years of follow-up. J Hand Surg Am 2017; 42: 838.e1-838.e8
    Search in Google Scholar
  • 42 Miller NJK, Davis TRC. Palmar plate capsulodesis for thumb metacarpophalangeal joint hyperextension in association with trapeziometacarpal osteoarthritis. J Hand Surg Eur Vol 2014; 39: 272-275
    Search in Google Scholar
  • 43 Martin-Ferrero M. Ten-year long term results of total joint arthroplasties with ARPE implant in the treatment of trapeziometacarpal osteoarthritis. J Hand Surg Eur Vol 2014; 39: 826-832
    Search in Google Scholar
  • 44 Lussiez B, Falaise C, Ledouw P. Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years. J Hand Surg Eur Vol 2021; 46: 961-967
    Search in Google Scholar
  • 45 Di Laura A, Hithi H. Battisti. et al. Wear of dual mobility cups; a review article. Int Orthop 2016; 41: 625-633
    Search in Google Scholar
  • 46 Boyer B, Neri T, Geringer J. et al. Long-term wear of dual mobiliy total hip replacement cups: explant study. Int Orthop 2018; 42: 41-47
    Search in Google Scholar
  • 47 Vissers G, Goorens CK, Vanmierlo B. et al. Ivory arthroplasty for trapeziometacarpal osteoarthritis: 10-year follow-up. J Hand Surg Eur Vol 2019; 44: 138-145
    Search in Google Scholar
  • 48 Tchurukdichian A, Guillier D, Moris V. et al. Results of 110 Ivory prostheses for trapeziometacarpal osteoarthritis with a minimum follow-up of 10 years. J Hand Surg Eur Vol 2020; 45: 213-222
    Search in Google Scholar
  • 49 Lenoir H, Erbland A, Lumens D. et al. Trapeziectomy and ligament reconstruction tendon interposition after failed trapeziometacarpal joint replacement. Hand Surg Rehabil 2016; 35: 21-26
    Search in Google Scholar
  • 50 Kaszap B, Daecke W, Jung M. Outcome comparison of primary trapeziectomy versus secondary trapeziectomy following failed total trapeziometacarpal joint replacement. J Hand Surg Am 2013; 38: 863-871
    Search in Google Scholar
  • 51 Davis TRC, Pace A. Trapeziectomy for trapeziometacarpal joint osteoarthritis: is ligament reconstruction and temporary stabilisation of the pseudarthrosis with a Kirschner wire important?. J Hand Surg Eur Vol 2009; 34: 312-321
    Search in Google Scholar
  • 52 Brennan A, Blackburn J, Thomson J. et al. Simple trapeziectomy versus trapeziectomy with flexor carpi radialis suspension: a 17-year follow-up of a randomized blind trial. J Hand Surg Eur Vol 2021; 46: 120-124
    Search in Google Scholar
  • 53 Burton RI, Pellegrini VD. Surgical management of basal joint arthritis of the thumb. Part II. Ligament reconstruction with tendon interposition arthroplasty. J Hand Surg Am 1986; 11: 324-332
    Search in Google Scholar
  • 54 Weilby A. Tendon interposition arthroplasty of the first carpo-metacarpal joint. J Hand Surg Br 1988; 13: 421-425
    Search in Google Scholar
  • 55 DelSignore JL, Accardi KZ. Suture suspension arthroplsty technique for basal joint arthritis reconstruction. Tech Hand Up Extrem Surg 2009; 13: 166-172
    Search in Google Scholar
  • 56 Spekreijse KR, Vermeulen GM, Kedilioglu MA. et al. The effect of a bone tunnel during ligament reconstruction for trapeziometacarpal osteoarthritis: a 5 year follow-up. J Hand Surg Am 2015; 40: 2214-2222
    Search in Google Scholar
  • 57 Rhee PC, Shun AY. Complications of trapeziectomy with or without supsension arthroplasty. J Hand Surg Eur Vol 2014; 33: 137-143
    Search in Google Scholar