Ligament reconstruction and tendon interposition versus trapeziectomy and hematoma distraction arthroplasty for treatment of trapeziometacarpal arthritis

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Abstract

Purpose of review

Osteoarthritis of the trapeziometacarpal joint is a common and debilitating condition. Numerous surgical treatments have been described with ligament reconstruction and tendon interposition being the most commonly performed. This review will compare ligament reconstruction and tendon interposition with the less technically demanding trapeziectomy and hematoma distraction arthroplasty.

Recent findings

Simple trapeziectomy is being revisited as a treatment for trapeziometacarpal arthritis. Recent studies have questioned the necessity of reconstructing the suspensory ligaments of this joint or the need to interpose tissue between the thumb metacarpal and scaphoid.

Summary

While less involved procedures such as trapeziectomy and hematoma distraction arthroplasty have shown early promise as an alternative to ligament reconstruction and tendon interposition, the latter remains the standard to which other procedures are compared. Until there are properly designed, well powered, prospective, randomized studies, with adequate follow-up, the most appropriate procedure will remain undetermined.

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