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Suspension arthroplasty effectively avoids first ray decalage; has better clinical and radiological results and; offers a support system less traumatic for structures of the carpus than interposition arthroplasty.
A clinical score and magnetic resonance imaging study revealed suspension arthroplasty could yield better outcomes of pain reduction, clinical score and recovery of grip strength, as per the study results published in the journal 'International Orthopaedics.'
Biological arthroplasties are the most widely used surgical techniques for the treatment of trapeziometacarpal osteoarthritis. In these arthroplasties, reconstruction of the trapeziometacarpal joint by a tendon graft is used. This study focused on distinguishing between two surgical techniques: interposition arthroplasty and suspension arthroplasty at a 12-month follow-up to investigate the clinical and radiographic results. All in all, 67 patients surgically treated for basal thumb osteoarthritis were stratified into two groups: 36 patients, (8 Males and 27 Females) (39 hands), treated using the interposition arthroplasty included in group A and 31 patients, (6 Males and 25 Females) (34 hands), treated using the suspension included in group B. Radiographic evaluation of both the groups was done using X-ray and MRI at 12 months. Clinical evaluation was done using DASH score, VAS, Kapandji test, Grind test, handgrip tests and ROM before the surgery and at final follow-up. In group A, 31 hands (79.4%) presented Kapandji score of 10 and eight hands (20.6%) had a Kapandji score of 8 at the final follow-up about Kapandji test. Six hands (17.6%) reported a Kapandji score of 8 and 28 patients (82.4%), a Kapandji score of 10 in group B. Considering the radial abduction, group A patients recovered on average 79.5° of abduction and in group B recovered on average 78°. Group B showed better values of DASH and VAS score. The mean decalage was 2.3 mm in group A and 0 mm in group B. In all tests, Jamar dynamometer had statistically better results for group B (handgrip test, pulp pinch and key pinch test).
The study authors, Matteo Guzzini et al.
concluded, that at the final follow-up, suspension arthroplasty seems to be
linked with better results at MRI for example absence of I ray decalage and
minor scaphoid subchondral oedema.
International Orthopaedics
Suspension arthroplasty versus interposition arthroplasty in the treatment of trapeziometacarpal osteoarthritis: a clinical and magnetic resonance imaging study
Matteo Guzzini et al.
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