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RegJoint interposition arthroplasty vs MiniTightRope fixation for rhizarthrosis treatment
Robert Mulh, MDs; Alja Pungercar, MD
Medical university Ljubljana, Novo mesto, Dolenjska, Slovenia
Purpose:
In our retrospective study we compared our older RegJoint spacer interposition arthroplasty technique with newer MiniTightRope fixation technique for one of the most common cases we get in hand surgery.
Methods:
We included 400 patients with Eaton-Littler stage II to IV arthrosis, that were operated between 2014 and 2022. We were able to collect 200 patients that we operated with MiniTightRope technique at least 2 years ago, so we have enough follow-up. Than we added 200 patients that we operated with RegJoint from 2014 until 2022. We compared VAS, QuickDash and Kapandji scores and grip strength 1, 3, 6, 12 and 24 months postOP and satisfaction measured as Mayo score after two years. We collected most of these information rutinely during check-ups at the doctor or physiotherapist.
Results:
Our patients were 41 to 83 years old, mean age was 61,3. 84% of them were women.
PreOP VAS at rest was 4,2 and it improved to 3,9/3,1/1,7/1,4/1,1 with RJ and to 2,5/1,9/0,7/0,4/0,4 with MTR 1/3/6/12/24 months postOP.
PreOP VAS in stress was 7,1 and it improved to 6,4/5,1/4/3,5/3,3 with RJ and to 4,2/3,1/2/1,1/1 with MTR.
PreOP QuickDash was 45,4 and it was 55,2/53,1/39,7/26/26,8 with RJ and 51,3/31,6/25,7/17,4/16,9 with MTR.
PreOP Kapandji score was 5,8 and it improved to 6,1/7,7/8,4/8,9/8,7 with RJ and to 7,8/8,5/8,9/9,2/9,3 with MTR.
PreOP grip strength 19,2kg to 12,6/17,9/20,7/22,4/22,8 with RJ and to 14,6/21,6/24,9/26,3/26,6 with MTR.
After two years most RJ patients had fair to good results according to Mayo score and 77% of them would choose to undergo the same surgery again, while most MTR patients had excellent results and 96% of them agreed to do it again.
Conclusion:
Althought many patients had satisfactory results with RJ technique, many of them developed complications such as osteolysis, STT arthrosis, CRPS and also hypestesias lowering their average scores we measured. 13% of them needed reoperation in two years time. We found out outcomes with MTR were statistically superior. In two years only 3% of MTR patients needed reoperation and they were from the time we stared using this technique what was not the case in RJ patients.
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