NEW APPROACHES IN THE TREATMENT OF RIZOARTHROSIS: RESULTS OF PROSTHETIC RE PLACEMENT AND COMPARASION WITH TRAPEZIECTOMY AND SUSPENSION ARTHROPLASTY

F. Rifino, T. Ladogana, F. Albano, M. Balducci, A. Massari, B. Moretti, G. Solarino

School of Medicine University of Bari “Aldo Moro” – AOU Consorziale – “Policlinico” – Department of Translational Biomedicine and Neuroscience “DiBraiN” Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, Bari, Italy

*Correspondence to:
Francesco Rifino. MD
School of Medicine,
AOU Consorziale Policlinico,
Department of Translational Biomedicine and Neuroscience “DiBraiN”
Neuroscience and Sense Organs,
Orthopaedic & Trauma Unit,
University of Bari Aldo Moro,
Piazza Giulio Cesare 11,
70124, Bari, Italy
e-mail: rifinofrancesco@gmail.com

Received: 22 November 2022 Accepted: 31 January  2023

ISSN: 1973-6401 Copyright © by Lab Publishers (2023) This publication and/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: All authors report no conflicts of interest relevant to this article.

ABSTRACT

Rhizoarthrosis is a degenerative disease of the first carpometacarpal joint; it causes pain and functional limitation of the thumb that progressively worsens until it affects the whole hand. The diagnosis is both clinical and radiological and the treatment in the early stages is conservative. When nonoperative measures fail, surgery is the only chance. There are many surgical options in the management of thumb arthrosis. The aim of this study is to compare the clinical and functional outcome after a prosthetic replacement vs trapeziectomy and suspension arthroplasty. From January 2020 to June 2021, 18 patients with diagnosis of rhizoarthrosis (Eaton’s grade II and III) were recruited from our unit. Eight patients were treated with prosthetic replacement while ten patients with trapeziectomy and suspension arthroplasty. The parameters evaluated were the fist closure force, the index thumb grip force, the mobility of the first ray with the Kapandji score and the ROM of all the joints of the first ray. The follow up was performed at 3, 6, 12 months. The group of patients undergoing prosthesis replacement showed a statistically significant difference both in the force of the thumb-index forceps and in the Kapandji score following the removal of the post-surgical splint. Comparing the groups at 6 months there was no statistically significant difference in strength, while there was a statistically significant difference in range of motion in favor of the prosthesis (9+-0,76) over trapeziectomy (7,38+-1,32). Comparing the groups at 12 months there was no statistically significant difference in range of movement, while there was a statistically significant difference strength in prosthetic group over trapeziectomy (10,37+-2,41). Our study demonstrated a significant improvement in mobility and index thumb gripper strength in patients undergoing prosthetic replacement compared to patients undergoing trapeziectomy. The latter remains a valid therapeutic option in patients in whom prosthetic replacement is contraindicated, with a considerable improvement in pain symptoms and thumb functionality.

KEYWORDS: rhizoarthrosis, osteoarthritis, trapeziometacarpal joint, surgical treatment, prosthetic replacement, trapeziectomy, suspension arthroplasty