Short-term outcomes of trapeziometacarpal artelon implant compared with tendon suspension interposition arthroplasty for osteoarthritis: a matched cohort study.
OBJECTIVE
To compare the short-term efficacy of the Artelon trapeziometacarpal (TMC) implant with that of total trapeziectomy and abductor pollicis longus (APL) tendon suspension interposition arthroplasty in TMC osteoarthritis.


METHODS
A single-center matched cohort study was designed. The Artelon cohort comprised 13 consecutive patients (10 women, 3 men; mean age, 54 years) operated on with Artelon implant arthroplasty. The APL cohort comprised 40 patients (33 women, 7 men; mean age, 58 years) randomly selected among 88 consecutive age-matched patients operated on with APL arthroplasty during the same period. The mean follow-up time was 13 (SD, 4) months for the Artelon group and 12 (SD, 3) months for the APL group. All patients completed the short-form Disabilities of the Arm, Shoulder, and Hand (QuickDASH) survey and a scale measuring thumb pain and related activity limitation, both scored 0 (best) to 100 (worst). Patient satisfaction was recorded. Physical examination was performed by a blinded therapist.


RESULTS
The median QuickDASH score was 25 for the Artelon group and 20 for the APL group; the median pain scores were 38 and 28, respectively; the differences were not statistically significant. In the Artelon group, 8 patients were satisfied, compared with 32 in the APL group; the adjusted odds ratio of not being satisfied following Artelon implant compared to APL arthroplasty was 4. The median grip strength as a percentage of the contralateral hand was 82% in the Artelon group and 95% in the APL group; the median pinch strength was 61% and 86%, respectively. No statistically significant differences were found in thumb palmar or radial abduction. Two Artelon patients had revision to APL arthroplasty.


CONCLUSIONS
The short-term outcomes of the Artelon TMC implant were not superior to those of tendon suspension interposition arthroplasty, a factor to be considered when comparing treatment cost effectiveness.


METHODS
Therapeutic III.
Jörheim
Maria
M
Department of Orthopedics Hässleholm-Kristianstad, Hässleholm Hospital, Hässleholm, Sweden.
Isaxon
Ingrid
I
Flondell
Magnus
M
Kalén
Peter
P
Atroshi
Isam
I
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D001672:Biocompatible Materials; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D050279:Metacarpal Bones / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D052581:Pinch Strength; D011140:Polyurethanes; D011183:Postoperative Complications / Q000209:etiology*; D051222:Trapezium Bone / Q000601:surgery*
D001672:Biocompatible Materials; D011140:Polyurethanes; C044690:polyetherurethane urea