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Indian Journal of Orthopaedics Surgery


The outcome of suspension arthroplasty in Thumb Carpometacarpal joint arthritis


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Author Details: Nazmuddin J Jetaji, Kiran S. Belsare, Shyam Thakkar, Prashant N. Gedam, Aseem N. Parekh

Volume : 2

Issue : 3

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 285

Article End Page : 288


Abstract

The trapeziometacarpal joint is most often affected by primary osteoarthritis or post-traumatic arthritis. The aims and objectives of the study was to evaluate the subjective and objective results of thumb carpometacarpal arthritis treated with Suspension arthroplasty and comparison of the results at our institution with those mentioned in the literature. This is the study of 10 patients who were treated with suspension arthroplasty and followed up postoperatively at six months or more, the average being 14.2 months. The test of significance applied was Wilcoxon signed-rank test. A p-value of < 0.05 was considered as significant. The patients were evaluated after surgery in the terms of Mayo’s wrist score, grip strength, pinch strength and pain.
Results: There were 8 females and 2 males, 8 right handed (dominant) and 2 left handed. The average age was 56 yrs with SD of 4.7 yrs. The preoperative Mayo’s wrist score was 44 which increased to 74.5 at the time of the longest follow up. The difference was statististically significant (p-value of < 0.05). The increase in grip strength was impressive and statistically significant. It increased from a preoperative mean of 42% of the opposite hand to 69%. The increase in pinch strength although was less impressive as compared to the grip strength as reflected in the Mayo’s wrist score. It increased from a mean of 45.8% of the opposite hand to 54.7%. VAS scores reduced from mean of 4.8 to 0.2 showing significant reduction in pain at the base of the thumb.
Conclusion: Our study highlights the importance of diagnosing and identifying this potentially treatable common condition which is often confused with other differential diagnoses. Ligament reconstruction and tendon interposition is an easy and reproducible technique to restore function and relieve pain in the joint.

Keywords:
Thumb, Arthritis, Carpometacarpal, Suspension, Arthroplasty