The surgical management for isolated scaphotrapeziotrapezoid (STT) osteoarthritis : a systematic review of the literature


Scaphotrapeziotrapezoid ; osteoarthritis ; treatment ; isolated ; surgical procedures ; STT ; complications ; efficacy ; safety

Published online: Jun 01 2020

Shah Jehan, Hafiz Javaid Iqbal, Muhammad M M Javaid, Khalid Mohammed Sharif

From the Department of trauma and orthopaedic surgery, Diana Princess of Wales Hospital Grimsby, UK


We performed a systematic review to find out the safety and efficacy of various procedures for isolated scaphotrapeziotrapezoid osteoarthritis.

Eleven articles were included. The most common procedure was arthroplasty with pyrocarbon implant (28%), followed by resection of distal pole of scaphoid with proximal trapezium and trapezoid resection (18%). The other procedures included trapeziectomy with ligament reconstruction and tendon interposition (LRTI) (14%), arthroscopic resection of distal scaphoid (11%), trapezium and trapezoid resection with LRTI (10%) and arthrodesis (10%).

Complications were noted in 18 (15%) patients. The most common complication (7.5%) was asymptomatic dorsal intercalated segmental instability (DISI) followed by dislocation of the pyrocarbon implant (3%). Fusion resulted in decreased range of motion and grip strength. The distal scaphoid resection was related to high rate of DISI. Although the pyrocarbon implant has a higher dislocation rate which requires revision surgery, this complication is avoidable with good surgical technique. Arthroplasty with pyrocarbon implant may be the first choice in younger patients.