title: Reconstruction of the trapeziometacarpal joint in inflammatory joint disease using interposition of autologous tendon or poly-L-D-lactic acid implants: a prospective clinical trial.
abstract: Interposition arthroplasty with bioreplaceable poly-L-D-lactic acid (PLDLA) implants has yielded promising results in reconstruction of rheumatoid hands. In this prospective clinical study we compared the PLDLA implant arthroplasty (n = 17) with that of tendon interposition (n = 12) for destruction of the trapeziometacarpal joint in arthritic patients. There was no significant difference between the two groups preoperatively. At one-year follow-up, the mean pain and function scores were 5 and 13 in the PLDLA group, and 19 and 43 in the tendon interposition group, respectively. At one-year follow-up the visual analogue scale (VAS) for function of the PLDLA group differed significantly from that of the tendon interposition group (p = 0.03). This difference was not found at three months postoperatively, and disappeared again at two-year follow-up. Otherwise, no significant difference was found between the groups in the pain or function scores, functional tests, or range of movement. Bioreplaceable interposition arthroplasty works at least as well as tendon interposition. The operation is easier.
authors.affiliation: Department of Orthopaedics, Päijät-Häme Central Hospital, Keskussairaalankatu 7, Lahti, Finland. raine.tiihonen@phsotey.fi
authors.forename: Raine P
authors.initials: RP
authors.lastname: Tiihonen
authors.forename: Eerik T
authors.initials: ET
authors.lastname: Skyttä
authors.forename: Kalevi
authors.initials: K
authors.lastname: Kaarela
authors.forename: Mikko
authors.initials: M
authors.lastname: Ikävalko
authors.forename: Eero A
authors.initials: EA
authors.lastname: Belt
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging; D001178:Arthroplasty / Q000379:methods; D001705:Bioprosthesis; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005387:Finland; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D019344:Lactic Acid / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011091:Polyesters; D011108:Polymers / Q000494:pharmacology; D011446:Prospective Studies; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013709:Tendon Transfer / Q000379:methods*; D014182:Transplantation, Autologous; D051223:Trapezoid Bone / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)