Surgical Treatment of Trapeziometacarpal Joint for Osteoarthritis by Trapezectomy and Interposition of Polylactic Acid Arex Trapezium Implant(Arex®615R).
Journal Title: Scholars Bulletin - Year 2015, Vol 1, Issue 2
Abstract
Abstract: Osteoarthritis of trapeziometacarpal joint (TM joint), typically presenting with pain, reproducible tenderness in the region of the TM joint, restricted the range of motion, deformation(shoulder sign) and grind test that causes repentance and pain, is relatively common and affects 50% of postmenopausal women and up to 25% of elderly men. The aim of this study was to evaluate author’s experience with arthroplasty as opposed to surgical treatment of degenerative disease of the TM joint. Authors have used Polylactic acid (PLA) braid rolled on itself AREX trapezium implant(Arex®615R) in Assuta Medical Center as part of surgical option together with trapeziectomy and arthrodesis in patients with Eaton type III-IV of TM joint osteoarthritis.Methods:12 patients (11female/1male) were operated in Assuta Medical Center between 2009and 2011.Pre-operation average DASH score were 80,4 (88-74).Following operation, the average degree of improvement in DASH score at six weeks was 32.8 (42-22), three months-20.7 (31-12) and one year-10.6(5-13). All patients significantly improved after operation as measured with the VAS scale and DASH score. At one year follow-up allpatients were free of pain. Two patients had complication as acute-on-chronic autoimmune reaction due to PLA degradation. It appears that trapezectomy and interposition arthroplasty using AREX trapezium implant is efficacious for treatingofosteo arthritis Eaton type III-IV of TM joint. Keywords: Trapeziometacarpal joint Osteoarthritis, Interposition Arthroplasty, Polylactic acid implant, Foreign body giant cells inflammatory response, Polylactic acid implant degradation
Authors and Affiliations
Lauren Gorelick, Ayala Rozano-Gorelick, Anwar Saab, Edward Ram
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