Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: Long Term Results.

Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-10-01 Epub Date: 2022-03-10 DOI:10.1055/a-1737-4541
Christian Herold, Janina Lange, Hans Oliver Rennekampff, Sixtus Allert, Max Meyer Marcotty
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引用次数: 2

Abstract

Background: Initial results after autologous fat transfer for treatment of thumb carpometacarpal joint osteoarthritis have been promising. But long-term results have not yet been available.

Methods: In a prospective study, 42 patients with thumb carpometacarpal joint osteoarthritis were observed for a mean time of 5 years after autologous fat transfer. Manual liposuction and centrifugation were performed. Pain rating according to numerous analogue pain scale; objective force of pinch grip and fist closure; and Disabilities of the Arm, Shoulder, and Hand questionnaire score (DASH score) before and after treatment were analysed.

Results: The average pain preoperatively was 8.0 ± 1.6 and 4.0 ± 3.0 after 5 years overall. Force and pinch force of the treated hand improved from 71% and 60% preoperative in comparison to the non-treated hand to 100% and 96%, respectively, 5 years after fat transplantation. There were similar improvements for the parameters strength and DASH score. All improvements were statistically significant. No serious adverse events were observed.

Conclusions: Autologous fat transplantation is a real alternative to trapeziectomy even in the long term in basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients compared with classical procedures such as trapeziectomy, and the superior long-term results compared with classical injection therapy, make this approach feasible as a first-line therapy in basal joint osteoarthritis of the thumb as it offers stable results and warrants a high patient satisfaction rate.

自体脂肪移植治疗拇指腕关节骨性关节炎:长期疗效。
背景:自体脂肪移植治疗拇指腕掌关节骨关节炎的初步结果是有希望的。但长期的结果还没有出来。方法:在一项前瞻性研究中,42例拇指腕掌关节骨性关节炎患者在自体脂肪移植后平均观察5年。进行手动抽脂和离心。根据众多模拟疼痛量表进行疼痛评级;握拳和握拳的客观力量;分析治疗前后手臂、肩膀和手部残疾问卷评分(DASH评分)。结果:术前平均疼痛8.0±1.6,术后5年平均疼痛4.0±3.0。脂肪移植后5年,与未治疗手相比,治疗手的力量和夹持力分别从术前的71%和60%提高到100%和96%。参数强度和DASH评分也有类似的改善。所有的改善都具有统计学意义。未观察到严重不良事件。结论:自体脂肪移植是一种真正的替代斜方切除术的方法,即使在长期治疗拇指基底关节骨性关节炎中也是如此。与传统手术(如斜方切除术)相比,该手术的侵袭性低,患者早期康复,与传统注射治疗相比,长期效果优越,使该方法作为拇指基底关节骨关节炎的一线治疗方法可行,因为它提供了稳定的结果,并保证了较高的患者满意度。
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