Surgical Outcomes of Suspension Arthroplasty with Dermal Allograft Interposition after Trapeziectomy: Comparison with Ligament Reconstruction and Interposition Using the Flexor Carpi Radialis Tendon.

IF 1.9 2区 医学 Q2 ORTHOPEDICS
Clinics in Orthopedic Surgery Pub Date : 2025-04-01 Epub Date: 2025-03-14 DOI:10.4055/cios24034
Shin Woo Choi, Joo-Yul Bae, Hyun June Lee, Ha Sung Park, Yun Jae Kim, Jae Kwang Kim
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引用次数: 0

Abstract

Background: Trapeziectomy with suspension arthroplasty is a reliable treatment for thumb carpometacarpal (CMC) osteoarthritis. We modified the suture suspension technique to add further support to maintain the arthroplasty space by interposition of the dermal allograft. Our aim was to investigate the surgical outcomes of our technique of suspension arthroplasty with dermal allograft interposition (SADI) compared with those of traditional ligament reconstruction with tendon interposition (LRTI) using a half-sling of the flexor carpi radialis (FCR) tendon.

Methods: This retrospective study enrolled 26 patients (29 thumbs) with thumb CMC arthritis who underwent trapeziectomy with traditional LRTI using the FCR tendon (15 thumbs; LRTI group) or SADI (14 thumbs; SADI group) between January 2017 and May 2022. Patient-reported outcomes (visual analog scale; the Disabilities of the Arm, Shoulder and Hand score; and patient-rated wrist evaluation), grip strength, and scaphometacarpal distance were measured at baseline and 3 and 12 months postoperatively. The operation time was checked by reviewing medical records. All measurements were compared between the 2 groups.

Results: Between baseline and 12-month postoperative follow-up, all patient-reported outcomes significantly improved in both groups. Patient-reported outcomes, grip strength, and scaphometacarpal distance showed no differences between the 2 groups at all follow-up assessments, except for the scaphometacarpal distance being significantly greater in the SADI group at 3 months postoperatively. The operation time was significantly shorter in the SADI group. No complication was observed in either group.

Conclusions: Our modified suture suspension arthroplasty technique using dermal allograft interposition results in markedly shorter surgical times with similar surgical outcomes compared with those of traditional LRTI using the FCR tendon. This procedure appears to be an effective alternative treatment for thumb CMC arthritis.

斜方切除术后真皮异体间置悬吊关节置换术的手术效果:与桡侧腕屈肌腱韧带重建和间置的比较。
背景:椎体切除术联合悬吊关节成形术是治疗拇指腕掌骨关节炎的可靠方法。我们改良了缝合悬挂技术,通过植入同种异体真皮来增加进一步的支持以维持关节置换术空间。我们的目的是研究我们的真皮异体移植物间置(SADI)悬挂式关节置换术的手术效果,并与使用桡侧腕屈肌腱(FCR)半吊带的传统韧带重建与肌腱间置(LRTI)的手术效果进行比较。方法:本回顾性研究纳入26例(29个拇指)拇指CMC关节炎患者,采用FCR肌腱行传统LRTI梯形切除术(15个拇指;LRTI组)或SADI组(14个拇指;SADI集团)在2017年1月至2022年5月期间。患者报告的结果(视觉模拟量表;手臂、肩部和手部残疾得分;在基线、术后3个月和12个月测量患者评定的腕关节评估、握力和舟掌距离。通过查阅医疗记录,确认了手术时间。比较两组间所有测量值。结果:在基线和术后12个月随访期间,两组患者报告的所有结果均显著改善。患者报告的结果、握力和舟掌骨距离在所有随访评估中,两组之间没有差异,除了SADI组在术后3个月时舟掌骨距离明显更大。SADI组手术时间明显缩短。两组均无并发症发生。结论:与使用FCR肌腱的传统LRTI相比,我们采用同种异体真皮植入的改良缝合悬吊关节置换术的手术时间明显缩短,手术效果相似。这个程序似乎是一个有效的替代治疗拇指CMC关节炎。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.50
自引率
4.00%
发文量
85
审稿时长
36 weeks
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