Arthroscopic Total Trapeziectomy for Thumb Carpometacarpal Arthrosis.

BACKGROUND: The purpose of this individual cohort study is to demonstrate safety and efficacy in removing the trapezium through minimally invasive arthroscopy.

METHODS: A prospective case series was performed on all arthroscopic total trapeziectomy procedures for thumb basal joint arthrosis between 2018 and 2022. Patients were followed for up to 1 year. All patients received an examination at each visit to include pain, range of motion, strength, and metacarpal height. Complications, concomitant procedures, and revision procedures were recorded as well.

RESULTS: A total of 49 arthroscopic trapeziectomy procedures were recorded for 46 patients. The average preoperative visual analog pain scale score was 8.8 out of 10, and the postoperative score was 1 out of 10. All patients had a resolution of the carpometacarpal grind test postoperatively. The average preoperative key pinch, 3-point chuck, and grip strength were 9.8 lbs/in2 , 7.8 lbs/in2 , and 45 lbs/in2 , respectively. Final 6-month postoperative key pinch, 3-point chuck, and grip strength were 11.0 lbs/in2 , 9.8 lbs/in2 , and 49.2 lbs/in2 , respectively. Metacarpal height subsided on average 50%. We report one revision and no cases of radial sensory neuritis or flexor tendon rupture.

CONCLUSIONS: Arthroscopic total trapeziectomy appears to be a safe and effective treatment for end-stage arthrosis of the thumb basal joint.

LEVEL OF EVIDENCE: 2b Therapeutic; Individual Cohort Study.