Purpose
The objective of this randomized controlled trial was to compare the 12-month postoperative
Michigan Hand Outcomes Questionnaire (MHQ) total score between patients with osteoarthritis
(OA) at the first carpometacarpal (CMC I) joint who underwent trapeziectomy with suspension-interposition
arthroplasty using the flexor carpi radialis (FCR) tendon and those receiving a human
dermal collagen template (allograft).
Methods
We included 60 patients with CMC I OA who met the indications for surgery. They were
randomized into 1 of 2 groups: trapeziectomy using the FCR tendon or trapeziectomy
with the allograft for suspension-interposition. Patients completed a set of questionnaires
including the MHQ and were clinically assessed at baseline, 6 weeks, and 3, 6, and
12 months after surgery. Complications were recorded.
Results
We operated on 29 patients using the FCR tendon; 31 patients received an allograft.
Baseline MHQ total scores significantly increased from 51 (95% confidence interval
[CI], 46–56) to 83 (95% CI, 78–87) and 53 (95% CI, 47–58) to 76 (95% CI, 69–84) by
12 months in the FCR and allograft groups, respectively. We found similar outcomes
for both groups at all follow-up assessments. Five complications occurred in the FCR
group, and 10 in the allograft group. Revision surgery was required for one allograft
patient.
Conclusions
The use of the FCR tendon or allograft for trapeziectomy with suspension-interposition
arthroplasty in patients with CMC I OA leads to similar outcomes with more complications,
mainly tendon irritations, associated with the latter. Therefore, we only use the
allograft in cases of severe instability requiring a larger amount of suspension-interposition
material or for revision procedures after failed suspension-interposition with the
FCR tendon.
Type of study/level of evidence
Therapeutic I.
Key words
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Article info
Publication history
Published online: September 09, 2017
Accepted:
July 24,
2017
Received:
January 18,
2017
Footnotes
This study was supported by an unspecific research grant from Surgical Device GmbH (Cham, Switzerland) and the GraftJacket was purchased at a reduced price.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
