title: Trapezium resection with suspension and interposition arthroplasty using acellular dermal allograft for thumb carpometacarpal arthritis.
abstract: OBJECTIVE
  Trapezium excision with ligament reconstruction and tendon interposition has proved to be highly effective in the treatment of thumb carpometacarpal joint arthritis. Donor-site morbidity from autograft harvest can be avoided by using an allograft. We report the outcomes after suspension and interposition arthroplasty using an acellular dermal allograft (GraftJacket; Wright Medical Technology, Inc., Arlington, TN) for thumb carpometacarpal arthritis.
  
  
  METHODS
  Eighty-nine patients (100 thumbs) had surgery for thumb carpometacarpal arthritis using acellular dermal allograft instead of flexor carpi radialis tendon autograft. Evaluation of the results was performed for 82 thumbs with adequate data. Each patient was followed up for a minimum of 12 months (average, 30 months). Pain levels, grip strength, key pinch strength, range of motion, and radiographic measurements were performed.
  
  
  RESULTS
  Between the preoperative and final follow-up measurements, patient pain levels (on a visual analog scale) were significantly reduced, from 6.2 to 0.7. Comparisons between preoperative and postoperative strength measurements showed an average 16% increase in grip strength and 19% increase in key pinch strength. No differences were found for radial abduction and palmar abduction data, respectively. Comparison with the preoperative x-rays showed the thumb metacarpal had subsided 31% of the arthroplasty space. No patient experienced a foreign body reaction or suffered an infection in our series.
  
  
  CONCLUSIONS
  Trapeziectomy with suspension and interposition arthroplasty using an acellular dermal allograft is highly effective for the treatment of thumb carpometacarpal arthritis. This procedure provides a safe and effective alternative to autograft for both ligament reconstruction and tendon interposition and eliminates the potential morbidity of autograft harvest.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Hand & Upper Extremity Surgery, Allegheny General Hospital, Pittsburgh, PA 15212, USA.
authors.forename: Zinon T
authors.initials: ZT
authors.lastname: Kokkalis
authors.forename: George
authors.initials: G
authors.lastname: Zanaros
authors.forename: Robert W
authors.initials: RW
authors.lastname: Weiser
authors.forename: Dean G
authors.initials: DG
authors.lastname: Sotereanos
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D052737:Carpometacarpal Joints / Q000601:surgery*; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D013933:Thumb; D014184:Transplantation, Homologous; D051222:Trapezium Bone / Q000601:surgery*
chemical_list: C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen