title: Long-term results after modified Epping procedure for trapeziometacarpal osteoarthritis.
abstract: BACKGROUND
  Thumb trapeziometacarpal joint (TMJ) arthritis is among the most common degenerative joint diseases of the hand and predominantly affects patients in their fifth or sixth decade of life. Mid-term results of the most common surgical procedures were inconclusive regarding the superiority of one particular treatment method. This study presents the long-term outcomes of a modified Epping procedure.
  
  
  METHODS
  Seventy-one patients underwent a modified Epping procedure with a flexor carpi radialis (FCR) tendon sling stabilizer. After a mean follow-up of 13 years, 39 patients were followed by questionnaire and 15 patients presented for clinical examination. Outcomes were evaluated by objective clinical measurements, radiographic evaluations, performance in DASH, as well as patients' perceived level of handicap during defined exercises.
  
  
  RESULTS
  Mean DASH score was 32.39. Within the cohort, 66.7 % of the patients were free of complaints. Among patients reporting complaints, perceived loss of strength was the main concern for the majority (15.4 %) of study participants. Grip and pinch strengths and range of motion did not differ significantly between operated and non-operated hands. One patient suffered rupture of ligament plasty and needed revision surgery.
  
  
  CONCLUSIONS
  Despite relatively high DASH scores, the overall outcome of the modified Epping procedure is encouraging. Subjective loss of strength is a main complaint among patients, whereas instability is less of concern.
authors: 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: Silvan M
authors: SM
authors: Klein
authors: Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany.
authors: Katharina
authors: K
authors: Wachter
authors: Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
authors: Michael
authors: M
authors: Koller
authors: Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Jody
authors: J
authors: Vykoukal
authors: Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany.
authors: Sebastian
authors: S
authors: Geis
authors: Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany.
authors: Juergen H
authors: JH
authors: Dolderer
authors: Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany.
authors: Markus
authors: M
authors: Loibl
authors: Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany.
authors: Lukas
authors: L
authors: Prantl
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D052737:Carpometacarpal Joints / Q000503:physiopathology / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012086:Reoperation; D013709:Tendon Transfer / Q000379:methods*; D013933:Thumb / Q000601:surgery*; D013997:Time Factors
keywords: Epping procedure; Ligament reconstruction; Long-term outcome; Tendon interposition; Trapeziometacarpal joint arthritis