A Short Series of Rolled Tendon Arthroplasty in Carpo-Metacarpal Joint Arthritis of Thumb

Abstract

Introduction: Trapezio metacarpal joint arthritis is the commonest of arthritis in hand. It occurs more in females after age of 40 years (post menopausal women). Pain appears in all thumb movements which incapacitates them to do their daily household work. There are various methods of treating this disease like conservative methods including NSAIDS and hot water fomentation; surgical methods like trapeziectomy, stabilizing ligamentoplasty, prosthetic replacement (silicon implats, steffee prosthesis etc, fusion of trapezio metacarpal joint and tapeziectomy with tendon interposition arthroplasty. Non surgical measures forms the first line of treatment with aim of preventing progression of disease, however, surgery becomes an option when symptoms are refractory to nonsurgical methods. Aim: To evaluate the outcomes of trapeziectomy with free rolled tendon palmaris longus interposition arthroplasty for moderate to severe osteoarthritis of trapezio metacarpal joint. Material and methods: We evaluated 10 patients (mean age 50, Eaton Littler stage 3 and 4) who underwent trapeziectomy and palmaris longus interposition arthroplasy for end stage osteoarthritis of thumb carpometacarpal joint. Clinical outcome parameters were determined preoperatively and at 3, 6, and 12 months postoperatively. Results: We have got excellent in 7 cases (9 thumbs), good in 2 cases, poor in 1 case. Conclusion: Rolled tendon arthroplasty using free rolled palmaris longus tendon with trapeziectomy is able to provide high quality results in moderate to severe osteoarthritis of trapezio metacarpal joint.