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. 2009 Mar;4(1):24-8.
doi: 10.1007/s11552-008-9130-2. Epub 2008 Sep 24.

Arthroscopic hemitrapeziectomy for first carpometacarpal arthritis: results at 7-year follow-up

Eric P Hofmeister  1 , Robert S Leak, Randall W Culp, A Lee Osterman
Affiliations

Arthroscopic hemitrapeziectomy for first carpometacarpal arthritis: results at 7-year follow-up

Eric P Hofmeister et al. Hand (N Y). 2009 Mar.

Abstract

The purpose of this study was to determine the outcome of arthroscopic hemitrapeziectomy combined with thermal capsular plication and temporary K-wire fixation in patients with painful thumb basal joint due to either osteoarthritis or posttraumatic arthritis. There were 18 thumbs that were evaluated in this retrospective study of arthroscopic hemitrapeziectomy of the distal trapezium in addition to a pancapsular thermal shrinkage at an average of 7.6-year follow-up. No patient has required further surgery. A subjective improvement in pain, pinch activities, strength, and range of motion (ROM) was noted in all patients, and no patient had further surgery on their thumb. On exam, no patient had a first carpal-metacarpal grind or laxity. Total ROM of the thumb axis decreased by 20%, but all patients could oppose to the fifth finger. Grip strength remained unchanged, key pinch improved from 8 to 11 lbs, and tip pinch improved from 4 to 5 lbs. Radiographs showed a metacarpal subsidence of 1.8 mm (0-4 mm). Four complications were noted: two cases of dorsal radial nerve neuritis, one rupture of the flexor pollicis longus, and one prolonged hematoma. Results demonstrate that arthroscopic hemitrapeziectomy and capsular shrinkage for first carpometacarpal arthritis is an effective technique that provides high patient satisfaction, a functional pain-free thumb, and a reliable rate of return to activity.

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Figures

Figure 1
Figure 1
Basic initial first CMC set-up, utilizing the 1-R portal for the 1.9-mm arthroscope and the 1-U portal for the “working portal.”
Figure 2
Figure 2
Arthroscopic view of a 2.9-mm burr used to remove a loose body (LB). Note the extensive eburnation of the trapezium (CM).
Figure 3
Figure 3
Fluoroscopic image of the resected trapezium stabilized with a K-wire.
See this image and copyright information in PMC

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