title: Long-term follow-up of trapeziectomy with abductor pollicis longus tendon interposition arthroplasty for osteoarthritis of the thumb carpometacarpal joint.
abstract: OBJECTIVE
  To evaluate the long-term clinical and radiographic outcomes of trapeziectomy with abductor pollicis longus tendon interposition arthroplasty for moderate to severe osteoarthritis of the thumb carpometacarpal joint (Eaton stages III-IV).
  
  
  METHODS
  We evaluated 13 patients (15 thumbs) who underwent trapeziectomy and abductor pollicis longus tendon interposition arthroplasty for end-stage osteoarthritis of the thumb carpometacarpal joint, at an average follow-up of 15 years. Subjective clinical outcomes evaluated included visual analogue scale scores and disability of arm shoulder and hand score questionnaires. Objective clinical evaluation included lateral pinch and grip tests, and a range of active and passive thumb movements. All patients underwent a radiological assessment by two independent senior radiologists. Wherever possible, results obtained from the operated thumbs were compared to the non-operated side.
  
  
  RESULTS
  At a mean of 15 years post operation (range 15-17 years), there was no statistical difference between the operated and non-operated hands with regards to grip and pinch strength. In all cases CMC and MCPJ range of motion in the operative hand was either equal to or greater than non-operative counterparts. Mean visual analogue scale score was 2.13 and mean DASH score was 16.85. Mean carpal height was 0.52 and mean trapezial space ratio was 0.163. There were no early or late complications recorded and no revision surgery was required.
  
  
  CONCLUSIONS
  It is the opinion of these authors that abductor pollicis longus tendon interposition arthroplasty is able to provide high-quality long-term results for patients who suffer from moderate to severe osteoarthritis of the thumb carpometacarpal joint.
  
  
  METHODS
  Therapeutic Level IV.
authors.affiliation: The Hand Surgery Unit, Asaf Harofeh Medical Centre, Sackler Medical School, Tel Aviv University, Zrifin, Israel.
authors.forename: Erez
authors.initials: E
authors.lastname: Avisar
authors.affiliation: The Hand Surgery Unit, Asaf Harofeh Medical Centre, Sackler Medical School, Tel Aviv University, Zrifin, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Elvey
authors.affiliation: The Hand Surgery Unit, Asaf Harofeh Medical Centre, Sackler Medical School, Tel Aviv University, Zrifin, Israel.
authors.forename: Ziv
authors.initials: Z
authors.lastname: Wasrbrout
authors.affiliation: The Hand Surgery Unit, Asaf Harofeh Medical Centre, Sackler Medical School, Tel Aviv University, Zrifin, Israel.
authors.forename: Maurice
authors.initials: M
authors.lastname: Aghasi
keywords: Abductor pollicis longus trapeziometacarpal; Carpometacarpal; Tendon interposition; Thumb osteoarthritis; Trapeziectomy