Abstract
Background: Pyrocarbon disk interposition for carpometacarpal (CMC) thumb joint osteoarthritis can be performed with a flexor carpi radialis (FCR) or abductor pollicis longus (APL) tendon strip. With the FCR technique, a ligament reconstruction is performed in addition to disk fixation, whereas with the APL technique the disk is simply secured in place. Our aim is to compare long-term postoperative outcomes between both techniques. Methods: In this observational study, we included 106 patients in 2 centers operated on between 2006 and 2011. We assigned patients to the FCR group or the APL group based on the respective tendon strip used. As a primary outcome, we analyzed postoperative key pinch. In addition, we analyzed postoperative tip pinch and tripod pinch, grip strength, range of motion, thumb height maintenance, and patient-reported outcome measures (PROMs). Results: The analysis showed clinically important stronger key pinch for the APL group (β = 1.28 kg). Tip pinch and grip strength showed higher outcome for the FCR group (β = 1.22 kg and 5.14 kg, respectively). Palmar abduction was in favor of the FCR group and opposition in favor of the APL group, but these were interpreted as not clinically relevant. Radiological thumb height maintenance and PROMs showed no clinical difference. Conclusions: Pyrocarbon disk interposition arthroplasty for CMC thumb joint osteoarthritis can be secured with an APL or FCR tendon strip. At long-term follow-up, use of an APL tendon strip results in significantly higher key pinch and better opposition. Tip pinch, grip strength, and palmar abduction were better after use of the FCR tendon strip. The choice of the tendon strip can be based on outcomes considered most important for the individual patient.
| Original language | English |
|---|---|
| Pages (from-to) | 87S-95S |
| Journal | Hand |
| Volume | 18 |
| Issue number | 2_suppl |
| Early online date | 27 Jan 2022 |
| DOIs | |
| Publication status | Published - Mar 2023 |
Bibliographical note
Funding Information:The authors thank Janna S. E. Ottenhoff and Bastiaan T. J. A. van Hoorn for their contribution on gathering data for this manuscript. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors received a research grant from Integra Life Sciences. This research grant is used for execution of our multicenter studies on outcomes of pyrocarbon disk interposition arthroplasty for the treatment of CMC thumb joint osteoarthritis.
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors received a research grant from Integra Life Sciences. This research grant is used for execution of our multicenter studies on outcomes of pyrocarbon disk interposition arthroplasty for the treatment of CMC thumb joint osteoarthritis.
Publisher Copyright:
© The Author(s) 2022.