Surgical Treatment of Carpometacarpal Arthritis
Barron and Catalano said, "History does repeat itself, and the story of the surgical treatment of basal joint arthritis is no exception." They noted that simple trapezial excision to remove the contact between arthritic trapezial joint surfaces gave way to more technical reconstructive procedures; however, it has since returned to favor to some extent. Early on, Gervis described simple trapeziectomy and demonstrated favorable long-term patient satisfaction. Concern about residual pain and shortening with less predictable patient satisfaction led to the development of various ligament stabilization procedures with and without trapezial excision. Methods of CMC joint arthroplasty expanded to include the implementation of silicone, metal, polyethylene, and biologic materials. Outcomes and complications to date favor reconstructive procedures that rely on autogenous tissue only. Additionally, comparative studies have found no significant difference in outcomes between simple excision and more complex LR and TI procedures. Based on diminished operative time, complexity, and complication risk, we recommend a minimal HDA or APL-FCR suture suspensionplasty.
Conclusion
Barron and Catalano said, "History does repeat itself, and the story of the surgical treatment of basal joint arthritis is no exception." They noted that simple trapezial excision to remove the contact between arthritic trapezial joint surfaces gave way to more technical reconstructive procedures; however, it has since returned to favor to some extent. Early on, Gervis described simple trapeziectomy and demonstrated favorable long-term patient satisfaction. Concern about residual pain and shortening with less predictable patient satisfaction led to the development of various ligament stabilization procedures with and without trapezial excision. Methods of CMC joint arthroplasty expanded to include the implementation of silicone, metal, polyethylene, and biologic materials. Outcomes and complications to date favor reconstructive procedures that rely on autogenous tissue only. Additionally, comparative studies have found no significant difference in outcomes between simple excision and more complex LR and TI procedures. Based on diminished operative time, complexity, and complication risk, we recommend a minimal HDA or APL-FCR suture suspensionplasty.
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