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Meniscal Allograft Arthroplasty for the Treatment of Trapeziometacarpal Arthritis of the Thumb
Paul Scott Shapiro, MD; William Beaumont Hospital; Edward Diao, MD; California Pacific Medical Center
William Beaumont Hospital, Royal Oak, MI, USA

Introduction: Arthritis at the trapeziometacarpal joint of the thumb is common. Several surgical options exist showing favorable results. Metacarpal subsidence, donor site morbidity, and foreign body reactions can be avoided using allograft. We report the outcomes after interposition of allograft knee meniscus for thumb trapeziometacarpal arthritis. Materials & Methods: Twenty-three patients (25 thumbs) had surgery for thumb trapeziometacarpal arthritis using knee meniscal allograft tissue. Eleven thumbs had a minimum of 24 months follow-up, 2 thumbs had a minimum of 12 months, and 12 thumbs had less than 6 months. DASH questionnaire scores, pain levels, grip strength, pinch strength, range of motion, and radiographic measurements were performed. Results: Between the preoperative and 24 month follow-up measurements, patient pain levels (on a visual analog scale) were reduced, from 7.7 to 0.9. There was a significant improvement in DASH scores from a mean of 75.6 preoperatively to 43.7 at 24 months follow-up. Comparisons between preoperative and postoperative strength measurements showed an average 28.6% increase in grip strength and 31.4% increase in key pinch strength. All patients were able to touch their thumb tip to the base of the small finger at the 6 months follow-up. Radiographic measurements of the trapeziometacarpal index from preoperative to latest follow-up decreased by 5.5%, and subluxation index measurements decreased 3.9%. There was no clinical or radiographic evidence of foreign body reaction, and no other complications occurred. Conclusion: Our results are comparable results to other surgical techniques for trapeziometacarpal arthritis with respect to pain, outcomes, strength, surgical time, and cost. We found superior results with regard to oppositional motion, metacarpal subsidence, and complications requiring revision surgery. These results support the use of this technique in the surgical management of Stage II and III arthritis of the trapeziometcarpal joint. Further follow-up and clinical studies are warranted.


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