Results of treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint with tendon allograft interposition

Abstract

The aim of the study was to determine if the use of tendon allografts in combination with distal scaphoid resection for the treatment of isolated STT arthrosis is a save procedure. We reviewed the postoperative complications, re-operations, clinical and radiological results of this treatment modality. A retrospective cohort study was conducted. Investigated parameters include wrist mobility (wrist extension and -flexion), strength (grip- and pinch strength), patient-reported outcome scores : Visual Analogue Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand score (Q-DASH) and Patient Rated Wrist/Hand Evaluation score (PRWHE) and radiographic measurements : scapholunate (SL) angle, radiolunate (RL) angle and capitolunate (CL) angle. Ten wrists were included in nine patients. No revision surgery was performed. Two patients had transient neuropraxia of the radial nerve. Postoperative flexion-extension arc was 112°. Grip-strength was significantly increased after surgery (20 to 28kg). The average VAS score the past week was 1.75 (range 0-6.7), the average maximum VAS score was 3.0 (range 0-10). The mean PRWHE score was 16.6 (range 0- 69). The mean Q-DASH score was 17.95 (range 0-51). The current study indicates that distal scaphoid resection for isolated STT arthritis is a save procedure with minimal complications. It significantly improves grip strength. Mobility of the wrist was similar to contralateral wrist after surgery. Pain postoperatively was very limited (low VAS scores) and good functional scores (Q-DASH and PRWHE) were noted. Our findings support the prior findings that excisional arthroplasty might worsen carpal instability.