Replacement for carpometacarpal OA had better function, more revisions vs trapeziectomy
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Results presented at the Virtual EFORT Congress showed joint replacement for treatment of carpometacarpal joint osteoarthritis led to better function, but a higher rate of complications and revision surgeries compared with trapeziectomy.
Saajan Ramji and colleagues performed a systematic review to compare functional and adverse outcomes between joint replacement and trapeziectomy techniques in the treatment of carpometacarpal joint OA. Researchers included DASH score, QuickDASH score and VAS score as the primary outcomes, while total complication, dislocation and revision surgery rates were considered the secondary outcomes.
Of the 1,909 studies identified, Ramji noted 14 studies with 1,005 patients were included in the review, of which 521 patients underwent joint replacement and 484 underwent trapeziectomy. Patients who underwent joint replacement had lower QuickDASH scores and lower disability, according to Ramji.
“Five studies reported pain. The mean difference was –0.49, with a confidence interval between –1.29 and 0.30,” Ramji said in his presentation. “This indicated no difference between pain scores postoperatively.”
He added patients who underwent joint replacement had a significantly higher key pinch strength, as well as a higher number of complications and revision surgeries.
“Patients need to be counseled clearly stating that joint replacement treatments can result in better function with similar pain,” Ramji said. “However, patients need to be aware of the greater risk of complications and the greater odds of requiring revision surgery.”
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Raj S, et al. Paper 1140. Presented at: Virtual EFORT Congress; June 30- July 2, 2021.
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