Carpometacarpal (CMC) Joint Arthritis
Conditions
Keywords
CMC arthritis, mini tightrope, tendon interposition, trapeziectomy
Brief summary
Thumb carpometacarpal osteoarthritis is a common cause of pain, weakness and functional disability. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) is considered a standard surgical procedure, whereas Mini TightRope suspensionplasty has been introduced to facilitate earlier mobilization while maintaining first metacarpal stability. This prospective randomized single-center clinical trial compares Mini TightRope suspensionplasty with LRTI in patients with symptomatic Eaton-Littler stage II-IV thumb carpometacarpal osteoarthritis. Fifty patients were randomized in a 1:1 ratio to undergo either Mini TightRope suspensionplasty or LRTI. Clinical and radiographic outcomes were evaluated preoperatively and at 3 months, 6 months, 1 year and 2 years postoperatively. The primary outcome was the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) score at 2 years. Secondary outcomes included pain, thumb opposition, grip strength, pinch strength, operative time, radiographic preservation of metacarpal height and complications.
Interventions
PROCEDUREMini tightrope suspensionplasty
Complete trapeziectomy followed by suspension of the first metacarpal using the Arthrex Mini TightRope suture-button system
Complete trapeziectomy with ligament reconstruction using the flexor carpi radialis tendon and tendon interposition.
Sponsors
Theodoros Mylonas
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Symptomatic thumb carpometacarpal osteoarthritis * Eaton-Littler stage II-IV * Failure of at least six months of conservative treatment * Ability to provide informed consent * Ability to comply with follow-up
Exclusion criteria
* Inflammatory arthritis * Previous thumb surgery * Concomitant carpal pathology * Incomplete radiographs * Inability to comply with rehabilitation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| quick DASH score | 2 years | Quick Disabilities of the Arm, Shoulder and Hand score measured preoperatively and during follow-up, with the primary endpoint at two years. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| VAS score | 2 years | Visual Analog Scale pain score |
| Kapandji score | 2 years | Kapandji thumb opposition score |
| Grip strength | 2 years | Grip strength using a dynamometer |
| Trapeziometacarpal Index | 2 years | the ratio between the distance from the base of the first metacarpal to the distal surface of the scaphoid and the total length of the first metacarpal |
Countries
Greece
Outcome results
None listed