Surgical treatment of carpometacarpal thumb arthritis with trapeziectomy and intra-tendon (FCR) suspension with one-loop APL: comparative cohort study.
Carpometacarpal thumb arthritis
Loop
Tendons
Trapeziectomy
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
25 Apr 2023
25 Apr 2023
Historique:
received:
23
07
2022
accepted:
04
04
2023
medline:
27
4
2023
pubmed:
26
4
2023
entrez:
25
4
2023
Statut:
epublish
Résumé
One of the current choices of treatment for Trapeziometacarpal (TMC) joint arthritis is trapeziectomy with ligament reconstruction and tendon interposition arthroplasty. The Ceruso's technique consists of complete trapezial excision and abductor pollicis longus (APL) tendon suspension. The APL tendon is tied to the flexor carpi radialis (FCR) tendon with two loops, one around it and one inside, and then used as interposition tissue. The purpose of the present study was to compare two different techniques of a trapeziectomy with ligament reconstruction and tendon interposition arthroplasty using the Abductor Pollicis Longus (APL) tendon, which is only Once Looped Around (OLA) versus Once Looped Inside (OLI) the Flexor Carpi Radialis (FCR) tendon. A single-center, retrospective study (Level of evidence: III) has been conducted on sixty-seven patients older than 55 years (33 OLI, 35 OLA), assessing clinical outcomes for at least 2 years of post-surgery follow-up. The outcomes were to assess and compare surgical outcomes comparing the two groups, in terms of subjective and objective evaluation for both groups at the last follow-up (primary outcome), and at the intermediate follow-ups (three and six months). Complications were also assessed. The authors found an improvement in pain, range of motion, and function, with equivalent results for both techniques. No subsidence was observed. FCR tendinitis was significantly reduced with OLI, as well as the need of post-operative physiotherapy. The one-loop technique allows for reduced surgical exposure, providing excellent suspension and clinical outcomes. Intra FCR loop should be preferred to improve post-surgical recovery. Level III study. This is a retrospective cohort study (written according to STROBE guidelines).
Sections du résumé
BACKGROUND
BACKGROUND
One of the current choices of treatment for Trapeziometacarpal (TMC) joint arthritis is trapeziectomy with ligament reconstruction and tendon interposition arthroplasty. The Ceruso's technique consists of complete trapezial excision and abductor pollicis longus (APL) tendon suspension. The APL tendon is tied to the flexor carpi radialis (FCR) tendon with two loops, one around it and one inside, and then used as interposition tissue. The purpose of the present study was to compare two different techniques of a trapeziectomy with ligament reconstruction and tendon interposition arthroplasty using the Abductor Pollicis Longus (APL) tendon, which is only Once Looped Around (OLA) versus Once Looped Inside (OLI) the Flexor Carpi Radialis (FCR) tendon.
METHODS
METHODS
A single-center, retrospective study (Level of evidence: III) has been conducted on sixty-seven patients older than 55 years (33 OLI, 35 OLA), assessing clinical outcomes for at least 2 years of post-surgery follow-up. The outcomes were to assess and compare surgical outcomes comparing the two groups, in terms of subjective and objective evaluation for both groups at the last follow-up (primary outcome), and at the intermediate follow-ups (three and six months). Complications were also assessed.
RESULTS
RESULTS
The authors found an improvement in pain, range of motion, and function, with equivalent results for both techniques. No subsidence was observed. FCR tendinitis was significantly reduced with OLI, as well as the need of post-operative physiotherapy.
CONCLUSIONS
CONCLUSIONS
The one-loop technique allows for reduced surgical exposure, providing excellent suspension and clinical outcomes. Intra FCR loop should be preferred to improve post-surgical recovery.
LEVEL OF EVIDENCE
METHODS
Level III study. This is a retrospective cohort study (written according to STROBE guidelines).
Identifiants
pubmed: 37098560
doi: 10.1186/s12891-023-06420-y
pii: 10.1186/s12891-023-06420-y
pmc: PMC10127042
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
328Informations de copyright
© 2023. The Author(s).
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