Trapezial arthroplasty with XXXX rubber implantation for advanced @entity571 of the trapeziometacarpal joint of the thumb.

@entity1 @entity625 @entity571 @entity174 @entity4 @entity1346 @entity158 @entity393
INTRODUCTION: @entity625 in the trapeziometacarpal joint of the thumb can cause @entity4 and @entity393 . Treatment options include arthrodesis, replacement arthroplasty and interposition arthroplasty. Our objective in this clinical study was to determine outcomes after trapezial arthroplasty with a @entity1346 rubber implant and the relationship between self-reported and measured outcomes. METHODS: At the Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ont., a tertiary care centre, we reviewed a series of 26 @entity1 with advanced @entity571 who underwent @entity1346 rubber trapezial arthroplasty. The follow-up averaged 6.5 years. We assessed the outcomes subjectively, and by clinical, functional and radiographic examination. RESULTS: Although 88% of @entity1 reported some improvement in @entity158 and satisfaction, when quantified the improvement was less impressive: only 5.7 (on a visual analogue scale of 1-10, poor-excellent) for @entity158 and 5.6 for satisfaction. Superior subjective results were reported by @entity1 older than 60 years. Osteoarthritic changes had caused pronounced functional impairment in the hands of @entity1 who underwent surgery and those who did not, so that any long-term benefit of surgery was not measurable. @entity1 had difficulty manipulating both small and large objects on the Jebsen's hand function test. Peri-implant and carpal radiographic lytic changes were observed in 90% of @entity1 . Six @entity1 (20%) required revision surgery (3 early, 3 late), including 1 with a pathologic @entity174 . CONCLUSIONS: Although clinical, functional and radiographic results were poor, they did not predict either satisfaction or @entity158 improvement reported by @entity1 , illustrating the need for a comprehensive standardized outcome evaluation to make informed decisions on the value of surgical intervention for @entity571 of the trapeziometacarpal joint.
