Meniscal allograft arthroplasty for the treatment of trapeziometacarpal arthritis of the thumb.
BACKGROUND
Arthritis at the trapeziometacarpal joint of the thumb is common. Several surgical options exist showing favorable results. We report the outcomes after interposition of allograft knee meniscus for thumb trapeziometacarpal arthritis.


METHODS
Twenty-three patients (25 thumbs) had surgery for thumb trapeziometacarpal arthritis using knee meniscal allograft tissue. Eleven thumbs had a minimum follow-up of 24 months, 2 thumbs had a minimum of 12 months, and 12 thumbs had less than 6 months. Disabilities of arm, shoulder, and hand (DASH) questionnaire scores, pain levels, grip strength, pinch strength, range of motion, and radiographic measurements were performed.


RESULTS
Between the preoperative and 24-month follow-up measurements, patient pain levels were reduced. There was a significant improvement in DASH scores. Comparisons between preoperative and postoperative strength measurements showed increase in grip strength and key pinch strength. Trapeziometacarpal subsidence was 5.5 %, and subluxation index measurements decreased 3.9 %. There was no clinical or radiographic evidence of foreign body reaction and no other complications occurred.


CONCLUSIONS
The results of meniscal allograft arthroplasty are comparable to other surgical techniques for trapeziometacarpal arthritis with respect to pain, outcomes, strength, oppositional motion, complications, surgical time, cost, and return to work. The results suggest that meniscal allograft arthroplasty is a viable option in the surgical management of stages II and III arthritis of the TM joint. Further follow-up and clinical studies are warranted.
Department of Orthopaedic Surgery, William Beaumont Hospital, 3535W. Thirteen Mile Road Suite #744, Royal Oak, MI 48073 USA ; Oakland University William Beaumont School of Medicine, 2200 N Squirrel Road, Rochester, MI 48309 USA ; Michigan Orthopaedic Institute, 26025 Lahser Road, Second Floor, Southfield, MI 48033 USA.
Paul S
PS
Shapiro
University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143 USA ; California Pacific Medical Center, 45 Castro Street, San Francisco, CA 94114 USA ; San Francisco Surgery Center, San Francisco, CA USA.
Edward
E
Diao
Department of Surgery, William Beaumont Hospital, 3601W. Thirteen Mile Road, Royal Oak, MI 48073 USA.
Lynn M
LM
Givens
Allograft; Arthritis; Arthroplasty; Meniscus; Thumb