title: Midterm results after modified Epping procedure for trapeziometacarpal osteoarthritis.
abstract: OBJECTIVE
  Various surgical procedures have been proposed for the treatment of trapeziometacarpal joint (TMJ) osteoarthritis. Despite an overall satisfactory outcome in most cases, some patients complain about inadequate performance at work, due to instability of the TMJ. We present a cross-sectional study of patients with TMJ arthritis who underwent a modified Epping procedure for increased TMJ stability.
  
  
  METHODS
  71 patients underwent a modified Epping procedure with a flexor carpi radialis tendon sling stabilizer. 59 patients were followed up after a mean time of 38 months. Residual pain was evaluated by visual analog scale. Functional outcome was quantified by pinch and grip strength, static two-point discrimination test, as well as DASH outcome scoring. Quality of life measures included patients' perceived satisfaction, activities of daily living (ADL), grip/pinch force and manual performance at work.
  
  
  RESULTS
  85 % of the patients regained full or partial manual performance during labor. Strength and ADL improved or remained the same in 81 %. In cases of a unilateral treatment, no difference in grip between the operated and nonoperated hand was observed. Mean tip pinch strength was 2.8 kg for the operated and 3.6 kg for the nonoperated hand. Mean pain level during rest was 0.98, 0.95 during mild activity, and 3.70 during strenuous activity. Mean DASH score was 26.6.
  
  
  CONCLUSIONS
  The great majority of patients who underwent this novel procedure benefited from an unaffected or improved work performance, due to good TMJ stability combined with adequate motion for ADL. Less favorable results were seen in patients with accompanying hand pathologies.
authors.affiliation: Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany. silvan.klein@klinik.uni-regensburg.de
authors.forename: Silvan M
authors.initials: SM
authors.lastname: Klein
authors.forename: Gisela
authors.initials: G
authors.lastname: Breindl
authors.forename: Michael
authors.initials: M
authors.lastname: Koller
authors.forename: Melanie
authors.initials: M
authors.lastname: Mielenz
authors.forename: Christina
authors.initials: C
authors.lastname: Roll
authors.forename: Bernd
authors.initials: B
authors.lastname: Kinner
authors.forename: Lukas
authors.initials: L
authors.lastname: Prantl
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D052737:Carpometacarpal Joints; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D017060:Patient Satisfaction; D013997:Time Factors; D051222:Trapezium Bone