Mid-Term Results of Surgical Treatment for Rhizarthrosis Using Interposition and Suspension-Interposition Arthroplasty

Abstract

Background. Rhizarthrosis is most commonly observed in individuals whose work and activities involve heavy use of the wrist. Conservative treatment methods are effective in the early stages of the disease, but in advanced stages, surgical intervention becomes the primary treatment approach. In recent years, resection interposition and resection suspension-interposition arthroplasty techniques for the first carpometacarpal joint have gained popularity. However, there is a lack of comparative studies on the effectiveness of these techniques based on key indicators.

The aim of this study was to compare the results of surgical treatment for stages II–IV rhizarthrosis using resection suspension-interposition arthroplasty and resection interposition arthroplasty of the first carpometacarpal joint.

Methods. This prospective cohort study included 85 patients with stages II–IV rhizarthrosis who underwent surgery between 2017 and 2022. Patients were divided into two groups. In the first group (52 patients), resection suspension-interposition arthroplasty of the first carpometacarpal joint was performed using an original technique. In the second group (33 patients), resection interposition arthroplasty was performed. The effectiveness of surgical treatment was assessed based on the intensity of pain using the Visual Analog Scale for Pain (VAS), upper limb function recovery assessed with the Disabilities of the Arm, Shoulder, and Hand (DASH) scale, measurement of the distance between the base of the first metacarpal bone and the distal pole of the trapezium bone on anteroposterior X-rays, and an increase in grip strength of the affected hand at 12 months postoperatively.

Results. At the 12-month follow-up, the first group showed superior results compared to the second group: a 73% improvement in DASH score (p<0.01); a 76% improvement in VAS (p = 0.000); a 60% increase in cylindrical grip strength (p = 0.010); and a 30% improvement in the measurement of the distance between the base of the first metacarpal bone and the distal pole of the trapezium bone (p<0.01).

Conclusion. Resection suspension-interposition arthroplasty of the first carpometacarpal joint is more effective than resection interposition arthroplasty in terms of pain relief, improvement in function and grip strength of the affected hand, and preservation of the distance between the base of the first metacarpal bone and the distal pole of the trapezium bone.

Keywords

rhizarthrosis / first carpometacarpal osteoarthritis / interposition arthroplasty / suspension arthroplasty / hand surgery

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