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Herren DB, Beaulieu JY, Calcagni M, Erling C, Jung M, Kaulich A, Mühldorfer-Fodor M, Papaloïzos M, Rosenkranz A, Vögelin E, Marks M. [Current Trends in the Implantation of the Touch Prosthesis at the Thumb Carpometacarpal Joint: Results of the 1st German-Speaking User Meeting]. HANDCHIR MIKROCHIR P 2024; 56:201-211. [PMID: 38861975 PMCID: PMC11166473 DOI: 10.1055/a-2321-9426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/09/2024] [Indexed: 06/13/2024] Open
Abstract
The introduction of the new generation of thumb carpometacarpal (CMC I) joint implants for the treatment of CMC I osteoarthritis has significantly broadened the scope of hand surgery in recent years. However, the technical demands of the procedure and the many details that need to be considered require appropriate training and a learning curve. To share experiences with the Touch CMC I prosthesis, we held the first German-speaking CMC I joint prosthetics user meeting in Zurich. After some basic introductory lectures on biomechanics and the principles of prosthetic fitting of the CMC I joint, the various challenges associated with CMC I joint prosthetics were discussed in interactive expert panels. Subsequently, cases were discussed in small groups under expert guidance and the respective conclusions were discussed in plenary. The main results of this symposium are summarised in this manuscript.
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Affiliation(s)
| | - Jean-Yves Beaulieu
- Unité Chirurgie de la main, Hôpitaux universitaires de Genève, Genf,
Switzerland
| | - Maurizio Calcagni
- Klinik für Plastische Chirurgie und Handchirurgie, Universitätsspital
Zürich, Zürich, Switzerland
| | | | - Martin Jung
- Handchirurgie, OCM Orthopädische Chirurgie München, München,
Germany
| | - Axel Kaulich
- Handchirurgie, Hanusch Krankenhaus, Orthopädie und Traumatologie, Wien,
Austria
| | | | | | - Anton Rosenkranz
- Abteilung Orthopädie und Traumatologie, Krankenhaus St. Josef Braunau,
Braunau am Inn, Austria
| | - Esther Vögelin
- Universitätsklinik für Plastische- und Handchirurgie, Inselspital,
Bern, Switzerland
| | - Miriam Marks
- Lehre, Forschung und Entwicklung, Schulthess Klinik, Zürich,
Switzerland
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Ghayyad K, Golovachev N, Sarli N, Hirsch D, Shojaie B, Kachooei AR. Effectiveness of Arthroscopic Debridement, Trapeziectomy, and Joint Replacement for Trapeziometacarpal Joint Osteoarthritis: A Meta-Analysis of Pre and Postoperative Pain Scores. Cureus 2024; 16:e54409. [PMID: 38510875 PMCID: PMC10954316 DOI: 10.7759/cureus.54409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/22/2024] Open
Abstract
Trapeziometacarpal joint osteoarthritis (TMJO) affects up to 33% of postmenopausal women, leading to pain, reduced mobility, and grip strength, with initial treatments focusing on non-surgical options like injections, orthoses, and exercises before considering surgery. A major challenge in managing TMJO involves selecting the optimal surgical strategy that is customized to individual clinical conditions. This study aimed to compare the effectiveness of three common surgical interventions for TMJO in relieving pain, including arthroscopic debridement (AD), trapeziectomy (TRAP), and joint replacement (JR). PubMed, Cochrane, Embase, and MEDLINE databases were queried according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies that presented pain outcomes following intervention for TMJO. Pain scores were reported preoperatively and postoperatively using the visual analog scale (VAS). Inclusion criteria included studies published in Q1 and Q2 journals and those with a follow-up of > six months. The final selection comprised 18 studies with 763 patients treated with AD (n = 102, 13%), TRAP (n = 428, 56%), and JR (n = 233, 31%) between 2010 and 2023, with a mean follow-up period of 38 ± 28 months. The studies included a total of 24 groups, five of which received AD, 13 of which received TRAP, and six of which received JR. The mean preoperative VAS was 6.7 ± 1.7, and the mean postoperative VAS was 1.7 ± 1.3 for all groups (P < 0.001). The meta-analysis demonstrated a mean preoperative pain score of 5.8 (95% CI, 4.1-7.5) for AD, 6.6 (95% CI, 5.7-7.5) for TRAP, and 7.8 (95% CI, 7.0-8.7) for JR. Postoperatively, there was a mean pain score of 2.2 (95% CI, 0.1-4.2) for AD, 1.4 (95% CI, 1.1-1.7) for TRAP, and 0.9 (95% CI, 0.6-1.2) for JR. This study showed that, if appropriately indicated, joint preservation with AD may be as effective as TRAP and JR for reducing pain associated with TMJO in the short term. However, the rate of conversion or revision should be assessed in future studies.
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Affiliation(s)
- Kassem Ghayyad
- Orthopedic Surgery, Rothman Orthopaedics Florida at AdventHealth, Orlando, USA
| | - Nikita Golovachev
- Orthopedic Surgery, Rothman Orthopaedics Florida at AdventHealth, Orlando, USA
| | - Nathan Sarli
- Orthopedic Surgery, Rothman Orthopaedics Florida at AdventHealth, Orlando, USA
| | - David Hirsch
- Orthopedic Surgery, Rothman Orthopaedics Florida at AdventHealth, Orlando, USA
| | - Babak Shojaie
- Plastic and Reconstructive Surgery, Klinikum Bremen-Mitte, Gottingen University of Medical Science, Bremen, DEU
| | - Amir R Kachooei
- Orthopedic Surgery, Rothman Orthopaedics Florida at AdventHealth, Orlando, USA
- Orthopedics, University of Central Florida, Orlando, USA
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Hamasaki T, Choinière M, Harris PG, Bureau NJ, Gaudreault N, Patenaude N. Biopsychosocial factors associated with pain severity and hand disability in trapeziometacarpal osteoarthritis and non-surgical management. J Hand Ther 2023; 36:647-657. [PMID: 36918308 DOI: 10.1016/j.jht.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 03/16/2023]
Abstract
BACKGROUND Trapeziometacarpal osteoarthritis (TMO) is one of the most prevalent and painful forms of hand osteoarthritis. PURPOSE This study aimed at (1) describing the TMO pain experience, (2) identifying biopsychosocial factors associated with pain intensity and disability, and 3) documenting the use of non-surgical management modalities. STUDY DESIGN Cross-sectional. METHODS Participants who presented for care for TMO were recruited from 15 healthcare institutions. They completed a questionnaire addressing sociodemographic, pain, disability, psychological well-being, quality of life (QoL), productivity, and treatment modalities employed. Multivariable regression analyses identified biopsychosocial factors associated with pain intensity and magnitude of disability. RESULTS Among our 228 participants aged 62.6 years, 78.1% were women. More than 80% of the participants reported average pain of moderate to severe intensity in the last 7 days. Nearly 30 % of them scored clinically significant levels of anxiodepressive symptoms. The participants' norm-based physical QoL score on the SF-12v2 was 41/100. Among the 79 employed respondents, 13 reported having missed complete or part of workdays in the previous month and 18 reported being at risk of losing their job due to TMO. Factors independently associated with more intense pain included higher pain frequency and greater disability, accounting for 59.0% of the variance. The mean DASH score was 46.1 of 100, and the factors associated with greater magnitude of disability were higher pain intensity, greater levels of depression, female sex, and lower level of education, explaining 60.1% of the variance. Acetaminophen, oral non-steroid anti-inflammatory drugs, cortisone injections, orthoses, hand massage/exercises, and heat/cold application were the most frequently employed modalities. Most participants never used assistive devices, ergonomic techniques, and psychosocial services. CONCLUSIONS Patients with TMO can experience severe pain, disability, disturbed emotional well-being, limited QoL and reduced productivity. As disability is associated with TMO pain, and depressive symptoms with disability, reducing such modifiable factors should be one of the clinicians' priorities.
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Affiliation(s)
- Tokiko Hamasaki
- Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada; Research Center of the CHUM, Montreal, Quebec, Canada; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
| | - Manon Choinière
- Research Center of the CHUM, Montreal, Quebec, Canada; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Patrick G Harris
- Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada; Research Center of the CHUM, Montreal, Quebec, Canada; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Nathalie J Bureau
- Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada; Research Center of the CHUM, Montreal, Quebec, Canada; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Nathaly Gaudreault
- Faculty of Medecine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Research Center of the CHUS, Sherbrooke, Quebec, Canada
| | - Nicolas Patenaude
- Faculty of Medecine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, Quebec, Canada
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Tchurukdichian A, Delgove A, Essid L, Moris V, di Summa PG, Camuzard O, Ornetti P, Zwetyenga N, Guillier D. Time to return to work after total trapeziometacarpal prosthesis. HAND SURGERY & REHABILITATION 2023:S2468-1229(23)00116-0. [PMID: 37356569 DOI: 10.1016/j.hansur.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES This study assessed return to work and prosthesis survival after trapeziometacarpal prosthesis surgery. MATERIAL AND METHODS A multicenter retrospective study was carried out on patients operated on between 2002 and 2020. All working patients who had undergone trapeziometacarpal prosthesis surgery were included. Return to work was defined as resuming the same full-time position. Postoperative events and their specific treatment and failure to return to work were reported. RESULTS 240 prostheses in 211 patients were included. The complications rate was 7.5%, with 97% prosthesis survival. 94.3% of patients returned to work, at a mean 48 days (range, 29-210 days; SD, 22.7 days), with no significant difference according to age. Twelve patients did not return to work, half of whom because of prosthetic complications. CONCLUSION Trapeziometacarpal arthroplasty enables most patients to return to work within 6 weeks. In this series, the prosthetic survival rate was 97%.
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Affiliation(s)
- A Tchurukdichian
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France; Chirurgie de la main, Cliniques de Valmy et de Drevon, 1 bis cours Général de Gaulle F-21000 Dijon, France
| | - A Delgove
- Service de chirurgie plastique, reconstructrice et esthétique, CHU de Bordeaux, place Amélie Raba Léon, 33000 Bordeaux, France
| | - L Essid
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France
| | - V Moris
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France
| | - P G di Summa
- Department of Plastic and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Rue de Bugnon 46, 1011 Lausanne, Switzerland
| | - O Camuzard
- Department of Plastic and Reconstructive Surgery, Hôpital Pasteur 2, CHU de Nice, Université Côte d'Azur, Nice, France
| | - P Ornetti
- Department of Rhumatology - Dijon University Hospital, Boulevard de Lattre de Tassigny, F-21000, Dijon, France
| | - N Zwetyenga
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France
| | - D Guillier
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery - Dijon University Hospital, Boulevard de Lattre de Tassigny F-21000, Dijon, France.
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Guerra Bresson H, Desmoineaux P, Maillot C, Delcourt T, Pujol N. Survey of practices in surgical management of trapeziometacarpal osteoarthritis in France in 2020. HAND SURGERY & REHABILITATION 2022; 41:613-623. [PMID: 35781064 DOI: 10.1016/j.hansur.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 06/13/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
The purpose of this study was to obtain an overview of French surgical practices for treating trapeziometacarpal osteoarthritis in 2020. An online survey was sent to 64 French hand surgeons: 32 authors of articles on carpometacarpal osteoarthritis of the thumb and 32 other surgeons randomly selected from the membership of the French Society of Hand Surgery (SFCM). The questions concerned demographic data, surgical practice, operative indications, choices for revision surgery, and eight clinical cases. The response rate was 56.2%. The most popular technique was trapeziometacarpal replacement (63.9%). During the previous 5 years, 31.6% of respondents had changed their practices, 69.2% of whom had adopted total joint replacement. Total trapeziectomy with ligamentoplasty and interposition was the second most frequent method. Most surgeons (77.8%) implemented medical treatment for 6 months to 1 year before resorting to surgery. In the clinical cases, agreement between surgeons was very low, with an overall inter-rater concordance coefficient of 0.182. Except for two cases (a young manual worker and a patient with a flattened trapezium) where no technique was significantly preferred, trapeziometacarpal replacement was chosen by a majority of respondents (p < 0.001). It was the most frequently performed surgical technique in France in 2020. However, there is no real consensus on choice of technique, which reflects the absence of guidelines.
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Affiliation(s)
- H Guerra Bresson
- Service de chirurgie orthopédique et traumatologique, Centre hospitalier de Versailles, 177 Rue de Versailles, 78150 Le Chesnay, France.
| | - P Desmoineaux
- Service de chirurgie orthopédique et traumatologique, Centre hospitalier de Versailles, 177 Rue de Versailles, 78150 Le Chesnay, France.
| | - C Maillot
- Service de chirurgie orthopédique et traumatologique, Hôpital Bichat-Beaujon, 46 Rue Henri Huchard, 75018 Paris, France
| | - T Delcourt
- Service de chirurgie orthopédique et traumatologique, Centre hospitalier de Versailles, 177 Rue de Versailles, 78150 Le Chesnay, France
| | - N Pujol
- Service de chirurgie orthopédique et traumatologique, Centre hospitalier de Versailles, 177 Rue de Versailles, 78150 Le Chesnay, France
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Ariana M, Afrasiabifar A, Najafi Doulatabad S, Mosavi A, Behnammoghadam M. The Effect of Local Heat Therapy versus Cold Rub Gel on Pain and Joint Functions in Patients with Knee Osteoarthritis. Clin Nurs Res 2021; 31:1014-1022. [PMID: 34308678 DOI: 10.1177/10547738211035502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was compared the effect of local heat therapy versus cold rub gel on pain and joint function in patients with knee osteoarthritis. One hundred seventeen patients with knee osteoarthritis were randomly assigned to cold rub gel, local heat therapy, and control group. Data were collected by knee injury and osteoarthritis outcome score at a week prior to the interventions and on weeks of 1, 2, 3, and 4 of the interventions. A significant difference was found between the three groups in terms of pain severity (p = .001), joint symptoms (p = .001), ADL function (p = .001), Sport and Recreation function (p = .001), except Knee related QOL (p = .3). Cold rub gel and heat therapy were both effective in improving pain and joint function in patients with knee osteoarthritis.
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Affiliation(s)
- Moslem Ariana
- School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | | | - Asadolah Mosavi
- School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
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