Short-Term Outcomes of Trapeziometacarpal Artelon Implant Compared With Tendon Suspension Interposition Arthroplasty for Osteoarthritis: A Matched Cohort Study.

Summary, in English

PURPOSE: To compare the short-term efficacy of the Artelon trapeziometacarpal (TMC) implant with that of total trapeziectomy and abductor pollicis longus (APL) tendon suspension interposition arthroplasty in TMC osteoarthritis. METHODS: A single-center matched cohort study was designed. The Artelon cohort comprised 13 consecutive patients (10 women, 3 men; mean age, 54 years) operated on with Artelon implant arthroplasty. The APL cohort comprised 40 patients (33 women, 7 men; mean age, 58 years) randomly selected among 88 consecutive age-matched patients operated on with APL arthroplasty during the same period. The mean follow-up time was 13 (SD, 4) months for the Artelon group and 12 (SD, 3) months for the APL group. All patients completed the short-form Disabilities of the Arm, Shoulder, and Hand (QuickDASH) survey and a scale measuring thumb pain and related activity limitation, both scored 0 (best) to 100 (worst). Patient satisfaction was recorded. Physical examination was performed by a blinded therapist. RESULTS: The median QuickDASH score was 25 for the Artelon group and 20 for the APL group; the median pain scores were 38 and 28, respectively; the differences were not statistically significant. In the Artelon group, 8 patients were satisfied, compared with 32 in the APL group; the adjusted odds ratio of not being satisfied following Artelon implant compared to APL arthroplasty was 4. The median grip strength as a percentage of the contralateral hand was 82% in the Artelon group and 95% in the APL group; the median pinch strength was 61% and 86%, respectively. No statistically significant differences were found in thumb palmar or radial abduction. Two Artelon patients had revision to APL arthroplasty. CONCLUSIONS: The short-term outcomes of the Artelon TMC implant were not superior to those of tendon suspension interposition arthroplasty, a factor to be considered when comparing treatment cost effectiveness. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

• Författare: Maria Jörheim; Ingrid Isaxon; Magnus Flondell; Peter Kalén; Isam Atroshi
• Avdelning/ar: Handkirurgi, Malmö; Ortopedi, Lund
• Publiceringsår: 2009
• Språk: Engelska
• Sidor: 1381-1387
• Publikation/Tidskrift/Serie: The Journal of Hand Surgery
• Volym: 34A
• Issue: 8
• Länkar: http://www.ncbi.nlm.nih.gov/pubmed/19683881?dopt=Abstract; http://dx.doi.org/10.1016/j.jhsa.2009.04.016
• Dokumenttyp: Artikel i tidskrift
• Förlag: Elsevier
• Ämne: Surgery; Orthopedics
• Status: Published
• Forskningsgrupp: Hand Surgery, Malmö
• ISBN/ISSN/Övrigt: ISSN: 1531-6564