Measurement of quality of life among patient undergoing arthroplasty of the thumb to treat CMC arthritis

Aita, Marcio Aurélio; Alves, Rafael Saleme; Longuino, Luis Felipe; Ferreira, Carlos Henrique Vieira; Ikeuti, Douglas Hideki; Rodrigues, Luciano Muller Reis

doi:10.1016/j.rboe.2016.06.003

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Original Articles • Rev. bras. ortop. 51 (04) • Jul-Aug 2016 • https://doi.org/10.1016/j.rboe.2016.06.003 copy

Measurement of quality of life among patient undergoing arthroplasty of the thumb to treat CMC arthritis^{^☆} ☆ Study conducted at Hospital Mario Covas, Santo André, SP, Centro Hospitalar Municipal de Santo André, SP; and Hospital de Ensino Padre Anchieta de São Bernardo do Campo, São Bernardo do Campo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To present the clinical and functional results, including measurement of quality of life, of patients undergoing trapeziometacarpal arthroplasty.

METHOD:

This was a prospective evaluation on 45 patients (53 thumbs) with a diagnosis of idiopathic rhizarthrosis who underwent resection arthroplasty and interposition of an uncemented Ascension^(r) implant, made of pyrocarbon. The clinical and functional results were analyzed through radiography, range of motion (ROM) in degrees (°), visual analog scale (VAS) for pain and the disability of arm, shoulder and hand (DASH) questionnaire for quality of life. In the group analyzed, 38 were women and seven were men, and their mean age was 63.17 years (range: 50-78). Eight patients were treated bilaterally.

RESULTS:

After 42.08 months of follow-up (range: 8-73), the subjective pain evaluation (VAS) score was 1.37 (range: 1-4). The complete ROM of the thumb increased to 95.75% (range: 75-100%) in relation to the contralateral side. The mean DASH questionnaire score was 9.98 (range: 1-18). The complication rate (negative events) was 11.32%. Five patients presented dislocation of the thumb prosthesis. All of them were reoperated by means of dorsal capsuloplasty using a portion of the retinaculum of the extensors as a graft, and good clinical evolution was achieved in these cases. One patient presented fracturing of the metacarpal and was treated by means of osteosynthesis using Kirschner wires.

CONCLUSION:

This method is effective for treating rhizarthrosis, according to the measurements made on the clinical and functional results, even after taking the complication rate into consideration. Moreover, it provides an improvement of quality of life for these patients.

Keywords:
Quality of life; Trapezium bone; Arthroplasty; Thumb

Stage	Radiological criteria – Eaton and Littler
I	Normal joint contours; the interlining articulate may be widened secondary to laxity or joint effusion
II	Slight narrowing of the interlining articulate; joint debris and osteophytes <2mmNormal ST joint
III	Marked degenerative changes with no interlining articulate, geodes, osteophytes, and sclerosis >2mm; variable degrees of subluxation; normal ST joint
IV	Similar to stage III but with degenerative changes of the ST joint

N	Age (years)	Sex	Dominance	Follow-up (months)	DASH	ROM (°)	VAS	Complications
1	68	F	ND	73	1	100	1
2	65	M	ND	72	1	98	1
3	62	F	D	69	6	91	2
4	63	F	D	69	1	100	1
5	60	F	D	68	1	95	2
6	65	F	D	67	1	93	1	Dislocation
7	59	F	D	65	18	88	3
8	70	F	ND	64	1	100	1
9	59	F	ND	62	1	100	1
10	75	F	ND	62	6	85	2	Metacarpal fracture
11	64	M	D	61	1	100	1
12	74	F	D	59	6	90	1	Dislocation
13	64	M	D	56	1	100	1
14	62	F	ND	56	12	83	2	Dislocation
15	56	M	D	56	6	80	1	Dislocation
16	68	F	D	55	1	100	1
17	70	F	D	55	1	100	1
18	60	F	D	55	1	100	1
19	67	F	D	54	1	100	1
20	61	F	ND	54	1	100	1
21	64	F	D	54	1	100	1
22	58	M	D	54	1	100	1
23	60	F	D	53	2	91	1	Dislocation
24	66	F	D	48	1	100	1
25	64	F	D	47	1	100	1
26	59	F	ND	47	1	100	1
27	56	F	D	43	1	100	1
28	69	F	L	42	12	85	2
29	64	F	ND	41	1	100	1
30	66	F	D	39	1	100	1
31	59	F	D	37	24	100	4
32	62	F	ND	35	1	100	1
33	60	M	D	34	1	100	1
34	60	F	D	34	1	100	1
35	67	F	D	31	1	100	1
36	61	F	ND	28	1	100	1
37	57	F	D	28	1	100	1
38	70	F	D	27	1	100	1
39	62	F	ND	26	1	100	1
40	50	M	D	24	12	78	3
41	70	F	D	18	1	100	1
42	63	F	ND	17	1	100	1
43	58	F	D	16	1	100	1
44	60	F	D	14	1	100	1
45	78	F	D	14	6	92	2
46	62	F	D	13	18	75	3
47	59	M	D	13	12	83	3
48	60	F	D	12	18	80	3
49	62	F	D	12	1	100	1
50	68	F	D	36	18	88	2
51	64	F	ND	25	1	100	1
52	59	F	D	28	1	100	1
53	58	F	ND	8	1	100	1

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: marcioaita@me.com (M.A. Aita).