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Significance and Implications of Partial Trapezoidectomy in Management of Scapho-Trapezio-Trapezoid (STT) Osteoarthritis
Diane Jo, MA; Ying Ku, BS; Jacob Lammers, DO; Ryan Khalaf, BS; R'ay Fodor, BS; Lianne Mulvihill, BA; Jose Reyes, BS; Mazen Al-Malak, MD; Brian A. Figueroa, MD; Antonio Rampazzo, MD, PhD; Bahar Bassiri Gharb, MD, PhD
Cleveland Clinic
2023-02-12
Presenter: Diane Jo
Affidavit:
The entirety of the project represents the original work of the authors and has not been previously published or presented.
Director Name: Bahar Bassiri Gharb
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Purpose:Trapeziectomy with partial trapezoid excision is a common surgical approach for scapho-trapezio-trapezoidal osteoarthritis (STTOA). This study seeks to determine the efficacy of performing partial trapezoidectomy in the treatment of STTOA.
Methods:All patients within the Cleveland Clinic Healthcare System who received a trapeziectomy with or without partial trapezoidectomy for isolated STTOA between 2003 and 2022 were reviewed. Demographic information, pain scores, and physical findings were recorded. Second metacarpal subsidence was calculated as a ratio of the change in scaphotrapezoid space (base of second metacarpal to scaphoid) preoperatively and postoperatively over the preoperative scaphotrapezoid space. Differences in subsidence and correlation between subsidence and pain scores were assessed between the two groups.
Results:Fifty-one patients who underwent 56 trapeziectomies were included. Of these, 28 underwent a partial trapezoidectomy. The average age at the time of surgery was 64 years (48–86), and 41 patients were female. Median follow-up time was 4.5 months (IQR=6). 79% of patients with partial trapezoidectomy had second metacarpal subsidence with a median subsidence of 32.8%(IQR=18), compared to 71% of patients in the trapeziectomy only group who had a median subsidence of 16%(IQR=21) (p=0.045). Pain scores decreased from 7 to 0 in the partial trapezoidectomy group (p<0.001) and from 6 to 2.5 in the trapeziectomy only group (p=0.003). There was no significant correlation between subsidence and pain in either group (p=0.43, p=0.31).
Conclusion:Trapeziectomy with and without partial trapezoidectomy reduced pain, but neither procedure was more effective than the other. Subsidence was not found to be a significant indicator of postoperative pain.
