Trapeziometacarpal arthrodesis in primary osteoarthritis: A minimum two-year follow-up study

We retrospectively reviewed 49 patients with primary osteoarthritis who und erwent 59 trapeziometacarpal (TM) arthrodeses to assess the efficacy of thi s procedure with respect to patient satisfaction and radiographic evidence of peritrapezial arthritis. The average patient age was 54 years (range, 41 -73 years) and the average follow-up period was 7 years (range, 2-20 years) . All TM arthrodeses used K-wires; 61 had a supplemental distal radius bone graft. There were 10 bilateral arthrodeses. There were 4 (7%) nonunions. T hree nonunions were painless and 1 was painful. There were 2 patients who r equired a second procedure; 1 had a painful nonunion that was successfully treated with a repeat arthrodesis and the other had a solid but painful thu mb that was treated with trapezial excision and soft tissue interposition. The average pain score at the time of the follow-up examination was 1.5 of 10. Thirty-three patients had postoperative radiographs; 7 had radiographic evidence of peritrapezial arthritis. Based on our findings we believe that isolated, symptomatic TM osteoarthritis in patients older than 40 years ol d is an indication of TM arthrodesis. (J Hand Surg 2001;26A:109-114. Copyri ght (C) 2001 by the American Society for Surgery of the Hand.).