Tratamiento quirúrgico de la rizartrosis. Experiencia personal y análisis comparativo de técnicas

Abstract

Introduction. Osteoarthritis of the thumb carpometacarpal (CMC) joint remains one of the main reasons for visiting a hand centre. Whenever the conservative treatment fails, the surgical approach will be offered. This treatment should be indicated individually for each patient, depending on various factors as the age, the degeneration degree, the functional demand and so on.Material and method. Between April 2011 and January 2017, 112 cases of thumb arthritis have been treated surgically. The average age of the patients was 53,89 years, with predominance of females (89,28%). The most frequently used technique was ligament reconstruction tendon interposition technique, following Weilby´s technique (85 cases). In 11 cases an arthroscopic arthroplasty was performed (ATK), in 11 patients a CMC fusion and in 5 a ligamentoplasty.Results. Out of the 112 patients, 63 patients have been controlled, with an average F-U of 19.5 months. Patients referred an improvement in pinch strength of 27,96 % in the Weilby´s technique group; 30,48 % in the ATK group, 60,71 % in the CMC fusion group and 31.42 % in the ligamentoplasty group. Focus on the pain, assessed by the visual analog scale, the improvement was 5.62, 5.98, 6 and 6.33 points respectively, compared to the preoperative situation. Conclusions. These outcomes confirm the usefulness of the suspension - interposition arthroplasty as an ideal technique for the common patient of CMC arthritis. In some cases, some factors such as age, functional demand or the degree of joint degeneration, lead us to look for other techniques in order to satisfy needs patient´s requests.