0
Articles   |    
Arthroplasty of the basal joint of the thumb. Long-term follow-up after ligament reconstruction with tendon interposition
MM Tomaino; VD Pellegrini; RI Burton
J Bone Joint Surg Am, 1995 Mar 01;77(3):346-355
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

Twenty-four thumbs of twenty-two patients were evaluated at an average of nine years (range, eight to eleven years) after a ligament reconstruction-tendon interposition arthroplasty for osteoarthrosis at the base of the thumb. The same group had also been examined two and six years postoperatively. The procedure had been performed as a primary operation in twenty-one thumbs and as a revision of a failed implant arthroplasty in three. Twenty-one (95 per cent) of the twenty-two patients had excellent relief of pain and were satisfied with the outcome. The average grip strength increased ten kilograms (p < 0.005), reflecting a 93 per cent improvement compared with the preoperative values. Similarly, the average tip pinch strength steadily improved, with an increase at the most recent examination of nearly one kilogram (p < 0.005) (65 per cent improvement). Improvements in the average key pinch strength, however, were first noted at the six-year follow-up examination and then tapered slightly; the most recent values reflected an average gain of 34 per cent but were not significantly different from the preoperative values. The tip of twenty-two (92 per cent) of the twenty-four thumbs was able to touch the base of the little finger, and the most recent average web angle (40 degrees) was unchanged from the value at the two-year follow-up examination. Stress radiographs showed an average subluxation of the metacarpal base of 11 per cent at nine years compared with 7 and 8 per cent at two and six years, respectively. Similarly, these radiographs demonstrated an average loss of height of the arthroplasty space of 13 per cent at nine years compared with 11 per cent at both of the earlier follow-up examinations. This modest deterioration of radiographic parameters was not predictive of an unsatisfactory outcome. The ligament reconstruction-tendon interposition arthroplasty provided a stable and functional reconstruction of the thumb, resulting in excellent relief of pain and a significant increase in strength for as long as eleven years after the procedure.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Guidelines
    The treatment of glenohumeral joint osteoarthritis. -American Academy of Orthopaedic Surgeons (AAOS) | 9/11/2009
    Results provided by:
    PubMed
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    03/19/2014
    Virginia - VIRGINIA COMMONWEALTH UNIVERSITY MEDICAL CENTER
    04/16/2014
    Georgia - Choice Care Occupational Medicine & Orthopaedics
    03/26/2014
    Massachusetts - Boston University Orthopedic Surgical Associates
    04/16/2014
    OH - OhioHealth Research and Innovation Institute (OHRI)