SURGICAL TREATMENT OF RHIZARTHROSIS: TRAPEZIECTOMY WITH OR WITHOUT LIGAMENTOPLASTY VERSUS TOTAL PROSTHESIS

Objective: The aim of this study was to review cases that underwent surgical treatment using two techniques: trapeziectomy with or without ligamentoplasty and arthroplasty with implant. Methods: Fifty-two hands that were surgically treated for rhizarthrosis between 1995 and 2008 were evaluated: 32 cases of trapeziectomy with or without ligamentoplasty (group A) and 20 with implant arthroplasty (group B). The mean follow-up for group A was 72 months and for group B, 23 months. There were no significantly different results with regard to pain, activities of daily living, mobility or strength. In the radiographic evaluation, it was found that the scaphometacarpal height was better preserved in group B. The mean time taken to achieve recovery was 10 weeks in group A and 4.5 in group B. Four cases with complications were recorded: one case of algoneurodystrophy in group A and two cases of dislocation and one case of fracture of the trapezium in group B. Results: The results from prostheses were better than the results from the traditional treatment for rhizarthrosis using trapeziectomy with or without ligamentoplasty because of the rapid recovery that prostheses provide. Conclusion: However, prostheses should be applied carefully, because there is a potential for complications relating to the implants.