Dwivedi Nishant, Calfee Ryan P, Wall Lindley B, Boyer Martin I, Brogan David, Dy Christopher J, Goldfarb Charles A
Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO.
J Hand Surg Glob Online. 2023 Aug 16;5(6):751-756. doi: 10.1016/j.jhsg.2023.07.006. eCollection 2023 Nov.
Trapeziectomy with tendon reconstruction/suspensionplasty (TRS) is the most commonly performed surgical procedure in the United States for treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). Trapeziectomy with suture tape suspensionplasty (STS) has been used recently at the study institution as an alternative surgical treatment option with perceived benefits of earlier return to function and reduced operative time. The purpose of this study was to compare patient outcomes following TRS versus STS for treatment of thumb CMC OA.
All patients who underwent primary, isolated TRS or STS for treatment of thumb CMC OA between 1/1/2014 and 9/1/2020 were analyzed. We assessed demographics and preoperative and postoperative patient-rated outcome scores including Patient-reported outcomes measurement information system scores as well as pain outcomes, satisfaction, and appearance at a mean of 2.6 years after surgery (minimum 6 months). Time to return to work and activities was compared between groups. Bivariate statistics compared outcomes between groups.
Ninety-four patients were included in the final study cohort, of which 53 underwent TRS and 41 underwent STS. There were no differences in preoperative, postoperative, or final patient-rated outcome scores between groups. Patients reported high global and appearance satisfaction scores at final follow-up in both groups. Mean tourniquet time was 15 minutes (26%) shorter and return to work was on average 3 weeks faster for the STS group.
There were no differences in postoperative patient-rated outcome scores between the STS and TRS groups. The STS group had a shorter surgical time and faster return-to-work after surgery.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
在治疗拇指腕掌关节（CMC）骨关节炎（OA）方面，大多角骨切除术联合肌腱重建/悬吊成形术（TRS）是美国最常用的外科手术。最近，在本研究机构中，采用缝线带悬吊成形术（STS）的大多角骨切除术作为一种替代手术治疗方案，具有功能恢复更早、手术时间缩短的优势。本研究的目的是比较TRS与STS治疗拇指CMC OA后的患者疗效。
分析了2014年1月1日至2020年9月1日期间因治疗拇指CMC OA而接受初次、单纯TRS或STS手术的所有患者。我们评估了人口统计学数据以及术前和术后患者报告的结局评分，包括患者报告结局测量信息系统评分以及疼痛结局、满意度和术后平均2.6年（至少6个月）时的外观情况。比较了两组恢复工作和活动的时间。采用双变量统计比较两组的结局。
最终研究队列纳入了94例患者，其中53例接受了TRS，41例接受了STS。两组术前、术后或最终患者报告的结局评分均无差异。两组患者在最终随访时均报告了较高的总体满意度和外观满意度评分。STS组的平均止血带时间缩短了15分钟（26%），平均恢复工作时间快了3周。
STS组和TRS组术后患者报告的结局评分无差异。STS组手术时间较短，术后恢复工作更快。
研究类型/证据水平：治疗性III级。
