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Open Access 01-09-2015

Meniscal allograft arthroplasty for the treatment of trapeziometacarpal arthritis of the thumb

Authors: Paul S. Shapiro, Edward Diao, Lynn M. Givens

Published in: HAND | Issue 3/2015

Abstract

Background

Arthritis at the trapeziometacarpal joint of the thumb is common. Several surgical options exist showing favorable results. We report the outcomes after interposition of allograft knee meniscus for thumb trapeziometacarpal arthritis.

Methods

Twenty-three patients (25 thumbs) had surgery for thumb trapeziometacarpal arthritis using knee meniscal allograft tissue. Eleven thumbs had a minimum follow-up of 24 months, 2 thumbs had a minimum of 12 months, and 12 thumbs had less than 6 months. Disabilities of arm, shoulder, and hand (DASH) questionnaire scores, pain levels, grip strength, pinch strength, range of motion, and radiographic measurements were performed.

Results

Between the preoperative and 24-month follow-up measurements, patient pain levels were reduced. There was a significant improvement in DASH scores. Comparisons between preoperative and postoperative strength measurements showed increase in grip strength and key pinch strength. Trapeziometacarpal subsidence was 5.5 %, and subluxation index measurements decreased 3.9 %. There was no clinical or radiographic evidence of foreign body reaction and no other complications occurred.

Conclusions

The results of meniscal allograft arthroplasty are comparable to other surgical techniques for trapeziometacarpal arthritis with respect to pain, outcomes, strength, oppositional motion, complications, surgical time, cost, and return to work. The results suggest that meniscal allograft arthroplasty is a viable option in the surgical management of stages II and III arthritis of the TM joint. Further follow-up and clinical studies are warranted.

Adams BD, Pomerance J, Nguyen A, Kuhl TL. Early outcome of spherical ceramic trapezial-metacarpal arthroplasty. J Hand Surg. 2009;34(2):213–8. doi:10.1016/j.jhsa.2008.10.017.CrossRef

Amadio PC. Outcomes assessment in hand surgery. What’s new? Clin Plast Surg. 1997;24(1):191–4.PubMed

Amadio PC, De Silva SP. Comparison of the results of trapeziometacarpal arthrodesis and arthroplasty in men with osteoarthritis of the trapeziometacarpal joint. Ann Chir Main Memb Super. 1990;9(5):358–63.

Athwal GS, Chenkin J, King GJ, Pichora DR. Early failures with a spheric interposition arthroplasty of the thumb basal joint. J Hand Surg. 2004;29(6):1080–4. doi:10.1016/j.jhsa.2004.06.012.CrossRef

Burton RI, Pellegrini Jr VD. Surgical management of basal joint arthritis of the thumb. Part II. Ligament reconstruction with tendon interposition arthroplasty. J Hand Surg. 1986;11(3):324–32.CrossRef

Carroll RE. Arthrodesis of the carpometacarpal joint of the thumb. A review of patients with a long postoperative period. Clin Orthop Relat Res. 1987;220:106–10.PubMed

Choung EW, Tan V. Foreign-body reaction to the Artelon CMC joint spacer: case report. J Hand Surg. 2008;33(9):1617–20. doi:10.1016/j.jhsa.2008.06.012.CrossRef

Cobb T, Sterbank P, Lemke J. Arthroscopic resection arthroplasty for treatment of combined carpometacarpal and scaphotrapeziotrapezoid (pantrapezial) arthritis. J Hand Surg. 2011;36(3):413–9. doi:10.1016/j.jhsa.2010.11.039.CrossRef

Creighton Jr JJ, Steichen JB, Strickland JW. Long-term evaluation of Silastic trapezial arthroplasty in patients with osteoarthritis. J Hand Surg. 1991;16(3):510–9.CrossRef

10.

Creighton RA, Cole BJ, Nicholson GP, Romeo AA, Lorenz EP. Effect of lateral meniscus allograft on shoulder articular contact areas and pressures. J Should Elb Surg. 2007;16(3):367–72. doi:10.1016/j.jse.2006.06.004.CrossRef

11.

Dhar S, Gray IC, Jones WA, Beddow FH. Simple excision of the trapezium for osteoarthritis of the carpometacarpal joint of the thumb. J Hand Surg (Br). 1994;19(4):485–8.CrossRef

12.

Diao E. Trapezio-metacarpal arthritis. Trapezium excision and ligament reconstruction not including the LRTI arthroplasty. Hand Clin. 2001;17(2):223–36.PubMed

13.

Diao E. Foreign-body reaction to the Artelon CMC joint spacer. J Hand Surg. 2009;34(6):1158–9. doi:10.1016/j.jhsa.2009.04.032.CrossRef

14.

Eaton RG, Glickel SZ. Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment. Hand Clin. 1987;3(4):455–71.PubMed

15.

Eaton RG, Glickel SZ, Littler JW. Tendon interposition arthroplasty for degenerative arthritis of the trapeziometacarpal joint of the thumb. J Hand Surg. 1985;10(5):645–54.CrossRef

16.

Edmunds JO. Current concepts of the anatomy of the thumb trapeziometacarpal joint. J Hand Surg. 2011;36(1):170–82. doi:10.1016/j.jhsa.2010.10.029.CrossRef

17.

Froimson AI. Tendon arthroplasty of the trapeziometacarpal joint. Clin Orthop Relat Res. 1970;70:191–9.PubMed

18.

Gallinet D, Gasse N, Blanchet N, Tropet Y, Obert L. Osteoarthritis of the trapeziometacarpal joint in men: different stakes. Results Surg Techn Chirurgie de la Main. 2011;30(1):40–5. doi:10.1016/j.main.2010.09.007.CrossRef

19.

Gangopadhyay S, McKenna H, Burke FD, Davis TR. Five- to 18-year follow-up for treatment of trapeziometacarpal osteoarthritis: a prospective comparison of excision, tendon interposition, and ligament reconstruction and tendon interposition. J Hand Surg. 2012;37(3):411–7. doi:10.1016/j.jhsa.2011.11.027.CrossRef

20.

Gervis WH. Excision of the trapezium for osteoarthritis of the trapezio-metacarpal joint. J Bone Joint Surg (Br). 1949;31b(4):537–9. illust.

21.

Giuffrida AY, Gyuricza C, Perino G, Weiland AJ. Foreign body reaction to Artelon spacer: case report. J Hand Surg. 2009;34(8):1388–92. doi:10.1016/j.jhsa.2009.05.006.CrossRef

22.

Glickel SZ, Kornstein AN, Eaton RG. Long-term follow-up of trapeziometacarpal arthroplasty with coexisting scaphotrapezial disease. J Hand Surg. 1992;17(4):612–20.CrossRef

23.

Goldner JL, Clippinger FW. Excision of the greater multangular bone as an adjunct to mobilization of the thumb. J Bone Joint Surg Am. 1959;41(4):609–25.PubMed

24.

Gray KV, Meals RA. Hematoma and distraction arthroplasty for thumb basal joint osteoarthritis: minimum 6.5-year follow-up evaluation. J Hand Surg. 2007;32(1):23–9. doi:10.1016/j.jhsa.2006.10.002.CrossRef

25.

Hartigan BJ, Stern PJ, Kiefhaber TR. Thumb carpometacarpal osteoarthritis: arthrodesis compared with ligament reconstruction and tendon interposition. J Bone Joint Surg Am. 2001;83(10):1470–8.PubMed

26.

Hommen JP, Applegate GR, Del Pizzo W. Meniscus allograft transplantation: 10-year results of cryopreserved allografts. Arthroscopy. 2007;23(4):388–93. doi:10.1016/j.arthro.2006.11.032.PubMedCrossRef

27.

Horlock N, Belcher HJ. Early versus late mobilisation after simple excision of the trapezium. J Bone Joint Surg (Br). 2002;84(8):1111–5.CrossRef

28.

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29(6):602–8. doi:10.1002/(sici)1097-0274(199606)29:6<602::aid-ajim4>3.0.co;2-l.PubMedCrossRef

29.

Kadiyala RK, Gelberman RH, Kwon B. Radiographic assessment of the trapezial space before and after ligament reconstruction and tendon interposition arthroplasty. J Hand Surg (Br). 1996;21(2):177–81.CrossRef

30.

Karlsson MK, Necking LE, Redlund-Johnell I. Foreign body reaction after modified silicone rubber arthroplasty of the first carpometacarpal joint. Scand J Plast Reconstr Surg Hand Surg. 1992;26(1):101–3.PubMedCrossRef

31.

Kochevar AJ, Adham CN, Adham MN, Angel MF, Walkinshaw MD. Thumb basal joint arthroplasty using abductor pollicis longus tendon: an average 5.5-year follow-up. J Hand Surg. 2011;36(8):1326–32. doi:10.1016/j.jhsa.2011.05.026.CrossRef

32.

Kokkalis ZT, Zanaros G, Weiser RW, Sotereanos DG. Trapezium resection with suspension and interposition arthroplasty using acellular dermal allograft for thumb carpometacarpal arthritis. J Hand Surg. 2009;34(6):1029–36. doi:10.1016/j.jhsa.2009.03.001.CrossRef

33.

Kuhns CA, Emerson ET, Meals RA. Hematoma and distraction arthroplasty for thumb basal joint osteoarthritis: a prospective, single-surgeon study including outcomes measures. J Hand Surg. 2003;28(3):381–9. doi:10.1053/jhsu.2003.50078.CrossRef

34.

Lins RE, Gelberman RH, McKeown L, Katz JN, Kadiyala RK. Basal joint arthritis: trapeziectomy with ligament reconstruction and tendon interposition arthroplasty. J Hand Surg. 1996;21(2):202–9. doi:10.1016/s0363-5023(96)80101-8.CrossRef

35.

Lollino N, Pellegrini A, Paladini P, Campi F, Porcellini G. Gleno-Humeral arthritis in young patients: clinical and radiographic analysis of humerus resurfacing prosthesis and meniscus interposition. Musculoskelet Surg. 2011;95 Suppl 1:S59–63. doi:10.1007/s12306-011-0122-y.PubMedCrossRef

36.

Muermans S, Coenen L. Interpositional arthroplasty with Gore-Tex, Marlex or tendon for osteoarthritis of the trapeziometacarpal joint. A retrospective comparative study. J Hand Surg (Br). 1998;23(1):64–8.CrossRef

37.

Muller GM. Arthrodesis of the trapeziometacarpal joint for osteoarthritis. J Bone Joint Surg. 1949;31B

38.

Murley AHG. Excision of the trapezium in osteoarthritis of the first carpo-metacarpal joint. J Bone Joint Surg Am. 1960;42B:502–7.

39.

Naidu SH, Poole J, Horne A. Entire flexor carpi radialis tendon harvest for thumb carpometacarpal arthroplasty alters wrist kinetics. J Hand Surg. 2006;31(7):1171–5. doi:10.1016/j.jhsa.2006.05.005.CrossRef

40.

Nanavati VN, Werner FW, Sutton LG, Klena J. Proximal row carpectomy: role of a radiocarpal interposition lateral meniscal allograft. J Hand Surg. 2009;34(2):251–7. doi:10.1016/j.jhsa.2008.10.030.CrossRef

41.

Nilsson A, Liljensten E, Bergstrom C, Sollerman C. Results from a degradable TMC joint Spacer (Artelon) compared with tendon arthroplasty. J Hand Surg. 2005;30(2):380–9. doi:10.1016/j.jhsa.2004.12.001.CrossRef

42.

Nilsson A, Wiig M, Alnehill H, Berggren M, Bjornum S, Geijer M, et al. The Artelon CMC spacer compared with tendon interposition arthroplasty. Acta Orthop. 2010;81(2):237–44. doi:10.3109/17453671003635835.PubMedCentralPubMedCrossRef

43.

Peimer CA. Long-term complications of trapeziometacarpal silicone arthroplasty. Clin Orthop Relat Res. 1987;220:86–98.PubMed

44.

Robinson PM, Muir LT. Foreign body reaction associated with Artelon: report of three cases. J Hand Surg. 2011;36(1):116–20. doi:10.1016/j.jhsa.2010.10.001.CrossRef

45.

Salem HM, Davis TR. Degenerative change at the pseudarthrosis after trapeziectomy at 6-year followup. Clin Orthop Relat Res. 2014;472(4):1160–5. doi:10.1007/s11999-013-2956-0.PubMedCentralPubMedCrossRef

46.

Sandvall BK, Cameron TE, Netscher DT, Epstein MJ, Staines KG, Petersen NJ. Basal joint osteoarthritis of the thumb: ligament reconstruction and tendon interposition versus hematoma distraction arthroplasty. J Hand Surg. 2010;35(12):1968–75. doi:10.1016/j.jhsa.2010.08.034.CrossRef

47.

Soejima O, Hanamura T, Kikuta T, Iida H, Naito M. Suspensionplasty with the abductor pollicis longus tendon for osteoarthritis in the carpometacarpal joint of the thumb. J Hand Surg. 2006;31(3):425–8. doi:10.1016/j.jhsa.2005.12.010.CrossRef

48.

Sollerman C, Hasselgren G, Westermark J, Herrlin K. Replacement of the os trapezium by polyurethane implants. Scand J Plast Reconstr Surg Hand Surg. 1993;27(3):217–21.PubMedCrossRef

49.

Swanson AB. Disabling arthritis at the base of the thumb: treatment by resection of the trapezium and flexible (silicone) implant arthroplasty. J Bone Joint Surg Am. 1972;54(3):456–71.PubMed

50.

Swigart CR. Arthritis of the base of the thumb. Curr Revi Musculoskelet Med. 2008;1(2):142–6. doi:10.1007/s12178-008-9022-7.CrossRef

51.

Thompson JS. Complications and salvage of trapeziometacarpal arthroplasties. Instr Course Lect. 1989;38:3–13.PubMed

52.

Tomaino MM, Pellegrini Jr VD, Burton RI. Arthroplasty of the basal joint of the thumb. Long-term follow-up after ligament reconstruction with tendon interposition. J Bone Joint Surg Am. 1995;77(3):346–55.PubMed

53.

Trumble TE, Rafijah G, Gilbert M, Allan CH, North E, McCallister WV. Thumb trapeziometacarpal joint arthritis: partial trapeziectomy with ligament reconstruction and interposition costochondral allograft. J Hand Surg. 2000;25(1):61–76. doi:10.1053/jhsu.2000.jhsu025a0061.CrossRef

54.

Vandenbroucke J, De Schrijver F, De Smet L, Fabry G. Simple trapezectomy for treatment of trapeziometacarpal osteoarthritis of the thumb. Clin Rheumatol. 1997;16(3):239–42.PubMedCrossRef

55.

Varitimidis SE, Fox RJ, King JA, Taras J, Sotereanos DG. Trapeziometacarpal arthroplasty using the entire flexor carpi radialis tendon. Clin Orthop Relat Res. 2000;370:164–70.PubMedCrossRef

56.

Varley GW, Calvey J, Hunter JB, Barton NJ, Davis TR. Excision of the trapezium for osteoarthritis at the base of the thumb. J Bone Joint Surg (Br). 1994;76(6):964–8.

57.

Weilby A. Surgical treatment of osteoarthritis of the carpo-meta-carpal joint of the thumb. Acta Orthop Scand. 1971;42(5):439–40.PubMed

58.

Wirth MA. Humeral head arthroplasty and meniscal allograft resurfacing of the glenoid. J Bone Joint Surg Am. 2009;91(5):1109–19. doi:10.2106/jbjs.h.00677.PubMedCrossRef

59.

Yang SS, Weiland AJ. First metacarpal subsidence during pinch after ligament reconstruction and tendon interposition basal joint arthroplasty of the thumb. J Hand Surg. 1998;23(5):879–83. doi:10.1016/s0363-5023(98)80167-6.CrossRef

Title: Meniscal allograft arthroplasty for the treatment of trapeziometacarpal arthritis of the thumb
Authors: Paul S. Shapiro
Edward Diao
Lynn M. Givens
Publication date: 01-09-2015
Publisher: Springer US
Published in: HAND / Issue 3/2015
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI: https://doi.org/10.1007/s11552-014-9737-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Meniscal allograft arthroplasty for the treatment of trapeziometacarpal arthritis of the thumb

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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