Intraoperative cartilage analysis of the first carpometacarpal joint - comparison with conventional staging according to Eaton and Littler.

IF 2 3区 医学 Q2 ORTHOPEDICS
Vincent März, Sören Könneker, Martynas Tamulevicius, Peter M Vogt
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引用次数: 0

Abstract

Introduction: Osteoarthritis of the first carpometacarpal joint is a common pathology of the hand, which may show an increasing prevalence in Germany due to the demographic development. In recent years, not only the current gold standard - the resection arthroplasty of the thumb saddle joint - has been used, but also therapeutic thumb saddle joint arthroscopy. In addition to the patient's clinical complaints, radiographic diagnostics have been used to decide on treatment, although it has not been proven whether there is a correlation between imaging and clinical complaints.

Materials and methods: Between 2020 and 2022, 20 articular surfaces of the thumb saddle joint undergoing resection arthroplasty for symptomatic basal thumb osteoarthritis were prospectively examined, mapped and compared with preoperative conventional radiographs.

Results: The evaluation of the corresponding articular surfaces showed a higher cartilage destruction at the articular surfaces of the trapezium compared to the first metacarpal. No correlation was found between the stage of osteoarthritis and the Eaton-Littler classification.

Conclusions: Overall, there is a patient-specific heterogeneity of the cartilage damage of the articular surface of the trapezium bone, as well in the metacarpal bone I base in relation to the radiographic diagnosis. Furthermore, an inhomogeneity of the radiographic stage of osteoarthritis of the carpometacarpal joint according to Eaton and Littler in relation to the intraoperatively assessed cartilage damage. The statistical significance of the surgically assessed cartilage damage in relation to the conventional radiographs could not be demonstrated. Thus, the treatment of symptomatic osteoarthritis of the carpometacarpal joint should primarily address the patient's individual complaints. The radiographic classification according to Eaton and Littler can be used as an additional factor to decide on the surgical procedure but should not delay the therapeutic treatment.

Level of evidence: III.

第一腕掌关节的术中软骨分析--与伊顿和利特尔的传统分期进行比较。
简介第一腕掌关节骨关节炎是手部的常见病,随着人口的发展,这种疾病在德国的发病率可能会越来越高。近年来,不仅采用了目前的金标准--拇指鞍状关节切除关节成形术,还采用了治疗性拇指鞍状关节关节镜手术。除了患者的临床主诉外,放射诊断也被用于决定治疗方法,但影像学与临床主诉之间是否存在相关性尚未得到证实:2020年至2022年间,对因症状性拇指基底骨关节炎接受切除关节成形术的20个拇指鞍状关节关节面进行了前瞻性检查、绘图,并与术前常规X光片进行了比较:对相应关节面的评估显示,与第一掌骨相比,梯形关节面的软骨破坏程度更高。骨关节炎的阶段与伊顿-利特勒分类法之间没有相关性:总体而言,根据放射学诊断,患者的梯形骨关节面软骨损伤以及掌骨I基底软骨损伤存在异质性。此外,根据伊顿(Eaton)和利特勒(Littler)理论,腕掌关节骨关节炎的影像学分期与术中评估的软骨损伤存在不一致性。手术评估的软骨损伤与传统X光片的统计学意义无法证实。因此,对有症状的腕掌关节骨关节炎的治疗应主要针对患者的个人主诉。根据伊顿和利特尔的放射学分类可作为决定手术治疗的额外因素,但不应延误治疗:证据等级:III.
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来源期刊
CiteScore
4.30
自引率
13.00%
发文量
424
审稿时长
2 months
期刊介绍: "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).
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