Acta Orthop Belg. 2023 Jun;89(2):257-264. doi: 10.52628/89.2.9448.
The aim of this retrospective study was to evaluate the potential bony erosion and the clinical and radiological results of primary trapeziectomy with RegjointTM interposition, in patients with peritrapezial arthritis. Data were recorded on twenty patients over a period of two years (January 2015-December 2016). On average 24 months, patients were reconvened for a post-operative evaluation (subjective evaluation of pain, function and patient satisfaction; clinical evaluation with strength and mobility measures; post-operative X-rays). On X-rays, 2 criteria were evaluated: the bony erosion and the shortening of the thumb column (trapezium+metacarpal height measure, ratio between first and second metacarpal bones, a new radiological assessment tool based on a trapezoid relationship gradation). In most patients, surgery relieved pain and offered good functional results, according to the Quick Disabilities of the Arm, Shoulder and Hand scale. Following surgery, our patients showed a subjective improvement, both in terms of pain and functional results. For plain X-ray, only 3 patients showed an osteolytic lesion (maximum of 2.8 millimeters) on the first metacarpal base. A statistically significant reduction in the thumb column height was generally observed on follow-up X-rays. However, all of these radiologic changes were present without any clinical impact. We show that the RegjointTM spacer is an available alternative in the surgical treatment of peritrapezial arthritis. We did not highlight any significant associated complications, no important adverse tissue reaction or bone erosion, no pain or functional disorder. Type of study/level of evidence Therapeutic IV.
本回顾性研究旨在评估原发性 trapeziectomy 联合 RegjointTM 植入物治疗 trapezial 关节炎的潜在骨侵蚀和临床及影像学结果。研究数据来自 2015 年 1 月至 2016 年 12 月期间的 20 名患者。平均 24 个月后,患者进行了术后评估(疼痛、功能和患者满意度的主观评估;力量和活动度测量的临床评估;术后 X 射线检查)。在 X 射线检查中,评估了 2 个标准:骨侵蚀和拇指柱缩短(trapezium+metacarpal 高度测量,第一和第二掌骨之间的比例,一种基于 trapezoid 关系分级的新影像学评估工具)。在大多数患者中,手术缓解了疼痛,并根据 Quick Disabilities of the Arm, Shoulder and Hand 量表提供了良好的功能结果。手术后,我们的患者在疼痛和功能结果方面都有主观改善。对于普通 X 射线,只有 3 名患者在第一掌骨基底处出现溶骨性病变(最大 2.8 毫米)。随访 X 射线通常观察到拇指柱高度的明显降低。然而,所有这些影像学变化都存在,但没有任何临床影响。我们表明,RegjointTM 间隔物是治疗 trapezial 关节炎的一种可行的替代方法。我们没有发现任何显著的相关并发症、重要的组织不良反应或骨侵蚀、疼痛或功能障碍。研究类型/证据水平治疗性 IV。