Total trapeziectomy for osteoarthritis of the trapeziometacarpal joint: Clinical and radiological outcomes in 21 cases with minimum 10-year follow-up

Introduction: Trapeziectomy is a technique of choice for osteoarthritis of the trapeziometacarpal joint, but few studies have assessed long-term radiological and clinical outcome in total trapeziectomy, mean follow-up being rather between 2 and 6 years in most cases. The main aim of the present study was to assess loss of trapezial space height at a minimum 10 years' follow-up. Secondary endpoints comprised functional outcome at the same follow-up. Hypothesis: There is systematic loss of trapezial space height, with discrepancy between radiological and clinical results, beyond 10 years' follow-up. Material and methods: Sixteen patients were retrospectively reassessed at a mean 13.8 years' follow-up (range, 10-17.8 years), for 21 total trapeziectomies. Criteria for the main endpoint comprised trapezial space height (TSH) and trapezial space ratio (TSR=TSH/thumb P1 phalanx length). Secondary endpoint criteria comprised pain, Kapandji opposition and retropulsion scores, active abduction, dynamometric parameters (key-pinch, tip-pinch and grip strength compared to the contralateral side), QuickDASH and satisfaction. Results: Mean TSH and TSR were respectively 3.7 mm (range, 0.5-6.1) and 0.14 (0.02-0.25) at last follow-up. Ranges of motion were conserved, with mean Kapandji score of 9.3 (6-10), Kapandji retropulsion score of 2.8 (1-4) and active abduction of 43 degrees (30-45 degrees). Strength measurements were comparable to contralateral values except for key-pinch, which was significantly weaker on the operated side (4.8 kg (1.5-8.5 kg) versus 5.5 kg (1.5-8 kg); p = 0.041). Mean QuickDASH was 23.5 (0-68.2), and overall satisfaction on VAS was 9.5/10 (6-10). Statistical testing confirmed the absence of correlation between radiological and clinical criteria. Discussion: Despite systematic trapezial space height loss, functional results were satisfactory and stable at a mean follow-up of 13.8 years. There was no correlation between radiological and clinical criteria in the long term. (C) 2020 Elsevier Masson SAS. All rights reserved.