Dreant Nicolas, Poumellec Marie-Anne
1 Polyclinique Saint François, Nice, France.
2 Centre Hospitalo-Universitaire de Nice, France.
Hand (N Y). 2019 Jan;14(1):59-65. doi: 10.1177/1558944718797341. Epub 2018 Sep 23.
Trapeziometacarpal prostheses have been used for more than 50 years in the treatment of first carpometacarpal joint arthritis. Even though this technique is more expensive than trapeziectomy, it has many advantages such as faster convalescence with better patient comfort and improved strength and range of motion. The aim of this study was to report the early functional results of a patient cohort treated with a dual mobility thumb carpometacarpal joint prosthesis.
A retrospective study was performed to assess the functional results of 25 patients treated for trapeziometacarpal advanced osteoarthritis (Eaton and Littler stage III) with 28 MOOVIS prostheses. Preoperative and postoperative assessments included pain, range of motion, and pinch and grip strength. The average follow-up time was 27.5 months.
The mean pain score measured by a visual analog scale was 8 preoperatively and 1 postoperatively. The mean preoperative Kapandji opposition score was 7 and counter-opposition score was 1; postoperative scores were 10 and 4, respectively. The grip strength improved after the surgery and the results were compared separately between dominant and nondominant sides. Final functional results were good: the mean Quick Disabilities of the Arm, Shoulder and Hand Questionnaire score was 12, and the mean Michigan Hand Outcomes score was 87%.
Total joint arthroplasty with a dual mobility prosthesis appears to be a satisfactory solution in our series. The absence of prosthesis instability encourages us to recommend this technique for the treatment of advanced trapeziometacarpal osteoarthritis for people having an activity without too many manual constraints.
大多角骨-第一掌骨假体用于治疗第一腕掌关节关节炎已有50多年历史。尽管该技术比大多角骨切除术费用更高,但它具有诸多优势,如康复更快、患者舒适度更高、力量和活动范围得到改善。本研究旨在报告一组接受双动拇指腕掌关节假体治疗患者的早期功能结果。
进行一项回顾性研究,以评估25例接受28个MOOVIS假体治疗大多角骨-第一掌骨晚期骨关节炎(伊顿和利特勒III期)患者的功能结果。术前和术后评估包括疼痛、活动范围以及捏力和握力。平均随访时间为27.5个月。
采用视觉模拟量表测得的平均疼痛评分术前为8分,术后为1分。术前平均卡潘迪对掌评分7分,反向对掌评分为1分;术后评分分别为10分和4分。术后握力有所改善,并分别对优势侧和非优势侧的结果进行了比较。最终功能结果良好:手臂、肩部和手部快速残疾问卷平均评分为12分,密歇根手部结果平均评分为87%。
在我们的系列研究中,双动假体全关节置换术似乎是一种令人满意的解决方案。假体无松动促使我们推荐该技术用于治疗活动不受太多体力限制的晚期大多角骨-第一掌骨骨关节炎患者。