TY - JOUR
T1 - Long-term results after modified Epping procedure for trapeziometacarpal osteoarthritis
AU - Klein, Silvan M.
AU - Wachter, Katharina
AU - Koller, Michael
AU - Vykoukal, Jody
AU - Geis, Sebastian
AU - Dolderer, Juergen H.
AU - Loibl, Markus
AU - Prantl, Lukas
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2015/10/22
Y1 - 2015/10/22
N2 - Introduction: 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. Conclusion: 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.
AB - Introduction: 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. Conclusion: 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.
KW - Epping procedure
KW - Ligament reconstruction
KW - Long-term outcome
KW - Tendon interposition
KW - Trapeziometacarpal joint arthritis
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U2 - 10.1007/s00402-015-2307-6
DO - 10.1007/s00402-015-2307-6
M3 - Article
C2 - 26306854
AN - SCOPUS:84941998122
SN - 0936-8051
VL - 135
SP - 1475
EP - 1484
JO - Archives of Orthopaedic and Trauma Surgery
JF - Archives of Orthopaedic and Trauma Surgery
IS - 10
ER -