Retrospective analysis of scaphoid trapezium pyrocarbon implant intervention in STT arthritis: a 3-year follow-up study
DOI:
https://doi.org/10.2340/jphs.v59.34985Keywords:
STT-arthritis, pyrocarbon, STPI, scaphotrapeziotrapezoidal, pyrocarbon implantAbstract
Aim: The purpose of this study was to evaluate clinical, patient rated and radiological outcome of the scaphoid trapezium pyrocarbon implant (STPI) at a minimum of three years follow-up.
Methods: Consecutive patients operated with the STPI due to scaphotrapeziotrapezoidal (STT) arthritis between 2012 and 2019 were included. Patients were evaluated preoperatively and annually after surgery for range of motion, grip strength, key pinch, quick-DASH, pain, and satisfaction. Radiographs were evaluated for implant position, signs of dorsal intercalated segment instability (DISI), capitolunate (CL) angle, scapholunate (SL) distance, and presence of osteophytes.
Results: Twenty-six patients (29 implants) were included. Seven implants were revised during the follow up, mainly due to pain: three implants were removed, four patients received a new STPI of a different size, leaving 22 implants in 20 patients available for follow up, 9 males and 11 females. Median age was 61.7 years (51–78 years). Median follow-up time was 68 months (37–105 months). Comparing preoperative status to the last follow-up, wrist extension and deviation, thumb abduction, and grip strength did not change. Key Pinch, quick DASH, pain, and patient satisfaction improved significantly at last follow-up. Radiographic signs of DISI were seen in six cases preoperatively and in 12 cases at last follow-up.
Conlusion: At a minimum of three years follow-up, the STPI used for STT-arthritis improve pain, quick-DASH result, and patient satisfaction significantly. ROM and grip strength did not change compared to preoperative values. Radiographic signs of carpal instability were common at the follow-up and the revision rate was high.
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Wollstein R, Clavijo J, Gilula LA. Osteoarthritis of the Wrist STT Joint and Radiocarpal Joint. Arthritis. 2012;242159.
https://doi.org/10.1155/2012/242159 DOI: https://doi.org/10.1155/2012/242159
Wu JC, Calandruccio JH. Evaluation and management of scaphoid-trapezium-trapezoid joint arthritis. Orthop Clin North Am. 2019;50(4):497–508.
https://doi.org/10.1016/j.ocl.2019.05.005 DOI: https://doi.org/10.1016/j.ocl.2019.05.005
Scordino LE, Bernstein J, Nakashian M, et al. Radiographic prevalence of scaphotrapeziotrapezoid osteoarthrosis. J Hand Surg Am. 2014;39(9):1677–82.
https://doi.org/10.1016/j.jhsa.2014.05.033 DOI: https://doi.org/10.1016/j.jhsa.2014.05.033
Tay SC, Moran SL, Shin AY, et al. The clinical implications of scaphotrapezium-trapezoidal arthritis with associated carpal instability. J Hand Surg Am. 2007;32(1):47–54.
https://doi.org/10.1016/j.jhsa.2006.10.021 DOI: https://doi.org/10.1016/j.jhsa.2006.10.021
Brown GD, 3rd, Roh MS, Strauch RJ, et al. Radiography and visual pathology of the osteoarthritic scaphotrapezio-trapezoidal joint, and its relationship to trapeziometacarpal osteoarthritis. J Hand Surg Am. 2003;28(5):739–43.
https://doi.org/10.1016/S0363-5023(03)00258-2 DOI: https://doi.org/10.1016/S0363-5023(03)00258-2
Wolf JM, Delaronde S. Current trends in nonoperative and operative treatment of trapeziometacarpal osteoarthritis: a survey of US hand surgeons. J Hand Surg Am. 2012;37(1):77–82.
https://doi.org/10.1016/j.jhsa.2011.10.010 DOI: https://doi.org/10.1016/j.jhsa.2011.10.010
Jehan S, Javaid Iqbal H, Javaid MM, et al. The surgical management for isolated scaphotrapeziotrapezoid (STT) osteoarthritis: a systematic review of the literature. Acta Orthop Belg. 2020;86(1):137–45.
Berkhout MJ, Bachour Y, Wessing D, et al. Distal pole resection of the scaphoid for the treatment of scaphotrapeziotrapezoid osteoarthritis. Hand (N Y). 2019;14(2):230–5.
https://doi.org/10.1177/1558944717735939 DOI: https://doi.org/10.1177/1558944717735939
Catalano LW, 3rd, Ryan DJ, Barron OA, et al. Surgical management of scaphotrapeziotrapezoid arthritis. J Am Acad Orthop Surg. 2020;28(6):221–8.
https://doi.org/10.5435/JAAOS-D-19-00539 DOI: https://doi.org/10.5435/JAAOS-D-19-00539
Stephens AR, Garcia BN, Rogers MJ, et al. Scaphotrapeziotrapezoid arthrodesis: systematic review. J Hand Surg Am. 2022;47(3):218–27 e2.
https://doi.org/10.1016/j.jhsa.2021.09.029 DOI: https://doi.org/10.1016/j.jhsa.2021.09.029
Saab M, Chick G. Trapeziectomy for trapeziometacarpal osteoarthritis. Bone Jt Open. 2021;2(3):141–9.
https://doi.org/10.1302/2633-1462.23.BJO-2020-0188.R1 DOI: https://doi.org/10.1302/2633-1462.23.BJO-2020-0188.R1
Ferris BD, Dunnett W, Lavelle JR. An association between scapho-trapezio-trapezoid osteoarthritis and static dorsal intercalated segment instability. J Hand Surg Br. 1994;19(3):338–9.
https://doi.org/10.1016/0266-7681(94)90084-1 DOI: https://doi.org/10.1016/0266-7681(94)90084-1
Garcia-Elias M. Excisional arthroplasty for scaphotrapeziotrapezoidal osteoarthritis. J Hand Surg Am. 2011;36(3):516–20.
https://doi.org/10.1016/j.jhsa.2010.12.016 DOI: https://doi.org/10.1016/j.jhsa.2010.12.016
Pegoli L, Zorli IP, Pivato G, et al. Scaphotrapeziotrapezoid joint arthritis: a pilot study of treatment with the scaphoid trapezium pyrocarbon implant. J Hand Surg Br. 2006;31(5):569–73.
https://doi.org/10.1016/J.JHSB.2006.05.006 DOI: https://doi.org/10.1016/J.JHSB.2006.05.006
Mathoulin C, Darin F. Arthroscopic treatment of scaphotrapeziotrapezoid osteoarthritis. Hand Clin. 2011;27(3):319–22.
https://doi.org/10.1016/j.hcl.2011.05.001 DOI: https://doi.org/10.1016/j.hcl.2011.05.001
Low AK, Edmunds IA. Isolated scaphotrapeziotrapezoid osteoarthritis: preliminary results of treatment using a pyrocarbon implant. Hand Surg. 2007;12(2):73–7.
https://doi.org/10.1142/S0218810407003523 DOI: https://doi.org/10.1142/S0218810407003523
Marcuzzi A, Ozben H, Russomando A. Treatment of scaphotrapezial trapezoidal osteoarthritis with resection of the distal pole of the scaphoid. Acta Orthop Traumatol Turc. 2014;48(4):431–6.
https://doi.org/10.3944/AOTT.2014.14.0156 DOI: https://doi.org/10.3944/AOTT.2014.14.0156
Pequignot JP, D’Asnieres de Veigy L, Allieu Y. Arthroplasty for scaphotrapeziotrapezoidal arthrosis using a pyrolytic carbon implant. Preliminary results. Chir Main. 2005;24(3–4):148–52.
https://doi.org/10.1016/j.main.2005.04.010 DOI: https://doi.org/10.1016/j.main.2005.04.010
Atroshi I, Gummesson C, Andersson B, et al. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: reliability and validity of the Swedish version evaluated in 176 patients. Acta Orthop Scand. 2000;71(6):613–8.
https://doi.org/10.1080/000164700317362262 DOI: https://doi.org/10.1080/000164700317362262
Voutilainen A, Pitkaaho T, Kvist T, et al. How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. J Adv Nurs. 2016;72(4):946–57.
https://doi.org/10.1111/jan.12875 DOI: https://doi.org/10.1111/jan.12875
Weerakkody Y. Dorsal intercalated segment instability. Reference article. Radiopaedia [Internet]. 2010 (cited 15-05-2023) Available from https://radiopaedia.org/articles/9709.
Tang JB, Avanessian B. Clinical reports: the importance of reporting a surgeon’s level of expertise. J Hand Surg Am. 2015;40(2):416–7.
https://doi.org/10.1016/j.jhsa.2014.10.036 DOI: https://doi.org/10.1016/j.jhsa.2014.10.036
BioProfile. stpi-surgical-technique-technique-chirurgicale-du- stpi. BioProfile.
Wolf JM, Schreier S, Tomsick S, et al. Radiographic laxity of the trapeziometacarpal joint is correlated with generalized joint hypermobility. J Hand Surg Am. 2011;36(7):1165–9.
https://doi.org/10.1016/j.jhsa.2011.03.017 DOI: https://doi.org/10.1016/j.jhsa.2011.03.017
Pegoli L, Pozzi A. Arthroscopic management of scaphoid-trapezium-trapezoid joint arthritis. Hand Clin. 2017;33(4):813–7.
https://doi.org/10.1016/j.hcl.2017.07.017 DOI: https://doi.org/10.1016/j.hcl.2017.07.017
Bellemere P. Pyrocarbon implants for the hand and wrist. Hand Surg Rehabil. 2018;37(3):129–54.
https://doi.org/10.1016/j.hansur.2018.03.001 DOI: https://doi.org/10.1016/j.hansur.2018.03.001
Bellemere P. Pyrocarbon implants for the basal thumb arthritis. Hand Surg Rehabil. 2021;40S:90–101.
https://doi.org/10.1016/j.hansur.2020.08.012 DOI: https://doi.org/10.1016/j.hansur.2020.08.012
Schindele SF, Giddins G, Bellemère P, editors. Arthroplasty in hand surgery : FESSH instructional course book 2020. Stuttgart: Thieme; 2021. DOI: https://doi.org/10.1055/b-0041-182684
Bellemere P. Medium- and long-term outcomes for hand and wrist pyrocarbon implants. J Hand Surg Eur Vol. 2019;44(9):887–97. DOI: https://doi.org/10.1177/1753193419871671
Wong SH, Chiu KY, Yan CH. Review article: osteophytes. J Orthop Surg (Hong Kong). 2016;24(3):403–10.
https://doi.org/10.1177/1602400327 DOI: https://doi.org/10.1177/1602400327
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