Surgical treatment of basal joint osteoarthritis of the thumb: Comparison between resection arthroplasty and trapezio-metacarpal arthrodesis

Introduction: We compared the results of patients with symptomatic osteoarthritis of the first carpametacarpal joint treated with either trapezio-metacarpal arthrodese or resection arthroplasty (without tendon interposition).

Method: From 1978 until 2000 fourteen CMC I arthrodeses in 13 patients (3 male, 10 female; average age 67 years; average follow-up 6 years) and 15 resection arthoplasties were performed in 13 patients (4 male, 9 female; average age 72 years; average follow-up 11 years).

Results: De visual analogue score for pain and satisfaction was for the arthrodesis 85 and 91 and for the arthroplasty 84 and 89. The average function score (maximum 30 points) was for both procedures 24 points. The average grip strength with the Jamar-meter was for the arthrodesis 20 N for the arthroplasty 18 N. The tip pinch and chuck pinch strength (maximum for both 5 points) were for the arthrodesis both 3 points and for the arthroplasty both 2 points. Complications for the arthrodesis: 2 non-unions, treated with rearthrodesis, 1 Sudeckse dystrofy. In the arthroplasty group 2 patients were treated for recurrent symptoms 2 and 8 years after initial surgery with reresection. In 9 patients the osteosynthesis material was removed due to patients complaints.

Conclusion: In this study both procedures lead to equal results.