Purpose
To evaluate the outcome of revision surgery for failed thumb carpometacarpal (CMC)
arthroplasty.
Methods
We retrospectively analyzed 32 patients with failed thumb CMC arthroplasty. The primary
reason for revision was pain caused by metacarpal subsidence. Revision surgery included
soft tissue interposition and distraction pinning to address the metacarpal subsidence.
Additional ligament reconstruction was performed in patients with thumb instability.
Eight patients required additional metacarpophalangeal joint fusion for concomitant
joint hyperextension. Eleven required additional partial excision of the trapezoid
for concomitant scaphotrapezoidal joint arthritis. All patients were evaluated clinically
and radiographically.
Results
Mean follow-up was 57 months (range, 24–121 months). Pain levels evaluated by visual
analog scale were significantly reduced in all patients after revision surgery. Mean
grip strength and key pinch strength significantly increased. Twenty-seven patients
achieved good functional results; those for 5 patients were fair.
Conclusions
This study showed that revision surgery with distraction pinning and soft tissue interposition
with or without ligament reconstruction was an effective treatment for failed CMC
arthroplasty of the thumb.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: September 06, 2017
Accepted:
July 21,
2017
Received:
September 26,
2016
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
