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大多角掌骨关节病的假体(触觉)手术与关节成形术的比较分析:功能结果及2年随访的患者满意度

Comparative Analysis of Prosthetic (Touch) and Arthroplastic Surgeries for Trapeziometacarpal Arthrosis: Functional Outcomes and Patient Satisfaction With a 2-Year Follow-Up.

作者信息

Piccirilli Eleonora, di Sette Priscilla, Rampoldi Michele, Primavera Matteo, Salvati Chiara, Tarantino Umberto

机构信息

Department of Orthopedic and Traumatology, University of Tor Vergata, Rome, Italy.

Department of Orthopedic and Traumatology, CTO Andrea Alesini, Rome, Italy.

出版信息

J Hand Surg Glob Online. 2024 Apr 14;6(4):500-503. doi: 10.1016/j.jhsg.2024.03.004. eCollection 2024 Jul.

Abstract

PURPOSE

Trapeziometacarpal (TMC) joint prosthesis poses its own challenges for the treatment of TMC arthrosis, especially when compared with the present gold standard, arthroplasty. The aim of this study was to highlight possible outcome differences and patients' satisfaction regarding the treatment of TMC arthrosis.

METHODS

We evaluated 100 patients with TMC arthrosis treated in two centers and divided into two groups: group A received TMC prosthesis (Touch), whereas group B was treated with arthroplasty, with a 2-year follow-up period.

RESULTS

In a comparative analysis, findings revealed group A's superiority in the shortened disabilities of the arm, shoulder and hand questionnaire scores at 1 and 6 months, with significant differences: 34.6% vs 67.1% and 2% vs 9.1%, respectively ( < .0001). Although group A also showed lower the shortened disabilities of the arm, shoulder and hand questionnaire scores at 3 months, this was not statistically significant. Notably, at 1 and 2 years, group A demonstrated better scores without statistical significance. The Kapandji score differed significantly at 6 months: 9.8 vs 9.1 ( = .029). Although the visual analog scale showed generally lower values for the prosthesis group, no statistical differences emerged. Additionally, the M1/M2 ratio became significant postoperatively, favoring group A ( < .05).

CONCLUSIONS

Trapeziometacarpal prosthesis shows promise for TMC arthrosis, enhancing function, thumb length, and patient recovery, warranting further research and x-ray guidance.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

摘要

目的

大多角骨-第一掌骨(TMC)关节假体在治疗TMC关节病时面临着自身的挑战,尤其是与当前的金标准——关节成形术相比。本研究的目的是突出TMC关节病治疗在可能的结果差异和患者满意度方面的情况。

方法

我们评估了在两个中心接受治疗的100例TMC关节病患者,并将其分为两组:A组接受TMC假体(Touch),而B组接受关节成形术,随访期为2年。

结果

在一项对比分析中,结果显示A组在术后1个月和6个月时,上肢、肩部和手部功能障碍简化问卷评分方面具有优势,差异显著:分别为34.6%对67.1%以及2%对9.1%(P<0.0001)。虽然A组在术后3个月时上肢、肩部和手部功能障碍简化问卷评分也较低,但差异无统计学意义。值得注意的是,在术后1年和2年时,A组评分更高,但差异无统计学意义。Kapandji评分在术后6个月时有显著差异:9.8对9.1(P=0.029)。虽然视觉模拟量表显示假体组的数值总体较低,但未出现统计学差异。此外,术后M1/M2比值具有显著差异,有利于A组(P<0.05)。

结论

大多角骨-第一掌骨假体在治疗TMC关节病方面显示出前景,可改善功能、拇指长度和患者恢复情况,值得进一步研究及X线引导。

研究类型/证据水平:治疗性研究III级。

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