Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand
BACKGROUND: Osteochondral defects of the carpometacarpal (CMC), metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate arthrodesis or arthroplasty. Meniscal allograft has been used for large joint resurfacing, but its application to smaller joints is less well underst...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057752/ https://www.ncbi.nlm.nih.gov/pubmed/33889471 http://dx.doi.org/10.1097/GOX.0000000000003520 |
_version_ | 1783680890456506368 |
---|---|
author | McCullough, Meghan C. Minasian, Raquel Tanabe, Kylie Rodriguez, Sandra Kulber, David |
author_facet | McCullough, Meghan C. Minasian, Raquel Tanabe, Kylie Rodriguez, Sandra Kulber, David |
author_sort | McCullough, Meghan C. |
collection | PubMed |
description | BACKGROUND: Osteochondral defects of the carpometacarpal (CMC), metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate arthrodesis or arthroplasty. Meniscal allograft has been used for large joint resurfacing, but its application to smaller joints is less well understood. We propose its use for hand joint resurfacing as an off-the-shelf alternative to address osteochondral defects and restore articular function. METHODS: Thirty-one patients with osteoarthritis of the CMC, MCP, or PIP joints underwent arthroplasty with meniscal allograft. Patient demographics and operative information were recorded. Preoperative Disability of the Shoulder, Arm, and Hand, Wong Baker pain, grip and pinch strength, and range of motion were compared to postoperative scores at 6 weeks, 6 months, and 1 year. RESULTS: Twenty-three women and 8 men, mean age 62.8 years, underwent 39 joint reconstructions, including CMC (n = 26), thumb MP (n = 2), thumb IP (n = 2), digit MP (n = 2), and digit PIP (n = 7). At 1 year, mean Disability of the Shoulder, Arm, and Hand scores decreased from 41.3 to 15.6 (P < 0.001) and pain scores from 6.9 to 1.0 (P < 0.001). Grip strength increased from 38.1 to 42.9 (P = 0.017) and radial and palmar abduction from 43.1 to 49.2 (P = 0.039) and 43.7 to 51.6 (P = 0.098), respectively. There were no complications related to the meniscus. CONCLUSIONS: Meniscal allograft represents an alternative to arthrodesis which obviates the need for a donor site and avoids many of the complications inherent to synthetic alternatives. Our early results demonstrate its successful use to reduce subjective pain and disability scores, improve objective strength measures, and maintain range of motion. |
format | Online Article Text |
id | pubmed-8057752 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-80577522021-04-21 Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand McCullough, Meghan C. Minasian, Raquel Tanabe, Kylie Rodriguez, Sandra Kulber, David Plast Reconstr Surg Glob Open Hand/Peripheral Nerve BACKGROUND: Osteochondral defects of the carpometacarpal (CMC), metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate arthrodesis or arthroplasty. Meniscal allograft has been used for large joint resurfacing, but its application to smaller joints is less well understood. We propose its use for hand joint resurfacing as an off-the-shelf alternative to address osteochondral defects and restore articular function. METHODS: Thirty-one patients with osteoarthritis of the CMC, MCP, or PIP joints underwent arthroplasty with meniscal allograft. Patient demographics and operative information were recorded. Preoperative Disability of the Shoulder, Arm, and Hand, Wong Baker pain, grip and pinch strength, and range of motion were compared to postoperative scores at 6 weeks, 6 months, and 1 year. RESULTS: Twenty-three women and 8 men, mean age 62.8 years, underwent 39 joint reconstructions, including CMC (n = 26), thumb MP (n = 2), thumb IP (n = 2), digit MP (n = 2), and digit PIP (n = 7). At 1 year, mean Disability of the Shoulder, Arm, and Hand scores decreased from 41.3 to 15.6 (P < 0.001) and pain scores from 6.9 to 1.0 (P < 0.001). Grip strength increased from 38.1 to 42.9 (P = 0.017) and radial and palmar abduction from 43.1 to 49.2 (P = 0.039) and 43.7 to 51.6 (P = 0.098), respectively. There were no complications related to the meniscus. CONCLUSIONS: Meniscal allograft represents an alternative to arthrodesis which obviates the need for a donor site and avoids many of the complications inherent to synthetic alternatives. Our early results demonstrate its successful use to reduce subjective pain and disability scores, improve objective strength measures, and maintain range of motion. Lippincott Williams & Wilkins 2021-04-20 /pmc/articles/PMC8057752/ /pubmed/33889471 http://dx.doi.org/10.1097/GOX.0000000000003520 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Hand/Peripheral Nerve McCullough, Meghan C. Minasian, Raquel Tanabe, Kylie Rodriguez, Sandra Kulber, David Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand |
title | Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand |
title_full | Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand |
title_fullStr | Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand |
title_full_unstemmed | Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand |
title_short | Functional Outcomes for Meniscal Allograft Interposition Arthroplasty of the Hand |
title_sort | functional outcomes for meniscal allograft interposition arthroplasty of the hand |
topic | Hand/Peripheral Nerve |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057752/ https://www.ncbi.nlm.nih.gov/pubmed/33889471 http://dx.doi.org/10.1097/GOX.0000000000003520 |
work_keys_str_mv | AT mcculloughmeghanc functionaloutcomesformeniscalallograftinterpositionarthroplastyofthehand AT minasianraquel functionaloutcomesformeniscalallograftinterpositionarthroplastyofthehand AT tanabekylie functionaloutcomesformeniscalallograftinterpositionarthroplastyofthehand AT rodriguezsandra functionaloutcomesformeniscalallograftinterpositionarthroplastyofthehand AT kulberdavid functionaloutcomesformeniscalallograftinterpositionarthroplastyofthehand |