Patricia L. Kirk

SAN ANTONIO — A simple treatment for basilar thumb arthritis that requires minimal convalescence may be just as effective as more complex procedures requiring a longer healing period, Nicholas J. Meyer, M.D., said at the joint annual meeting of the American Society for Surgery of the Hand and the American Society of Hand Therapists.

The procedure consists of a trapezium excision to stabilize the first and second metacarpal bases, followed by packing of the trapezial space with Gelfoam and suture suspensionplasty, explained Dr. Meyer of St. Croix Orthopaedics, Stillwater, Minn.

Dr. Meyer and his associates treated 42 patients with the procedure. The outcomes were evaluated using the disabilities of the arm, shoulder, and hand (DASH) survey, measures of grip and pinch strength, and radiographic assessment.

Radiographic follow-up showed that shortening of the metacarpal-scaphoid space occurred at an average of 4 mm within 2 months after surgery. Age, sex, or other diagnoses appeared to have no effect on this result.

Approximately 90% of patients reported satisfaction with their results, and 86% said they would repeat the treatment and recommend it to a friend. Ten percent were neutral or expressed dissatisfaction with the outcome.

“The results in this cohort of patients show satisfaction rates similar to other more complex procedures,” Dr. Meyer noted.

However, he said that a direct comparison study may be necessary to compare this procedure with trapeziectomy and the more complex procedures, such as ligament reconstruction and tendon interposition.

SAN ANTONIO — A simple treatment for basilar thumb arthritis that requires minimal convalescence may be just as effective as more complex procedures requiring a longer healing period, Nicholas J. Meyer, M.D., said at the joint annual meeting of the American Society for Surgery of the Hand and the American Society of Hand Therapists.

The procedure consists of a trapezium excision to stabilize the first and second metacarpal bases, followed by packing of the trapezial space with Gelfoam and suture suspensionplasty, explained Dr. Meyer of St. Croix Orthopaedics, Stillwater, Minn.

Dr. Meyer and his associates treated 42 patients with the procedure. The outcomes were evaluated using the disabilities of the arm, shoulder, and hand (DASH) survey, measures of grip and pinch strength, and radiographic assessment.

Radiographic follow-up showed that shortening of the metacarpal-scaphoid space occurred at an average of 4 mm within 2 months after surgery. Age, sex, or other diagnoses appeared to have no effect on this result.

Approximately 90% of patients reported satisfaction with their results, and 86% said they would repeat the treatment and recommend it to a friend. Ten percent were neutral or expressed dissatisfaction with the outcome.

“The results in this cohort of patients show satisfaction rates similar to other more complex procedures,” Dr. Meyer noted.

However, he said that a direct comparison study may be necessary to compare this procedure with trapeziectomy and the more complex procedures, such as ligament reconstruction and tendon interposition.

SAN ANTONIO — A simple treatment for basilar thumb arthritis that requires minimal convalescence may be just as effective as more complex procedures requiring a longer healing period, Nicholas J. Meyer, M.D., said at the joint annual meeting of the American Society for Surgery of the Hand and the American Society of Hand Therapists.

The procedure consists of a trapezium excision to stabilize the first and second metacarpal bases, followed by packing of the trapezial space with Gelfoam and suture suspensionplasty, explained Dr. Meyer of St. Croix Orthopaedics, Stillwater, Minn.

Dr. Meyer and his associates treated 42 patients with the procedure. The outcomes were evaluated using the disabilities of the arm, shoulder, and hand (DASH) survey, measures of grip and pinch strength, and radiographic assessment.

Radiographic follow-up showed that shortening of the metacarpal-scaphoid space occurred at an average of 4 mm within 2 months after surgery. Age, sex, or other diagnoses appeared to have no effect on this result.

Approximately 90% of patients reported satisfaction with their results, and 86% said they would repeat the treatment and recommend it to a friend. Ten percent were neutral or expressed dissatisfaction with the outcome.

“The results in this cohort of patients show satisfaction rates similar to other more complex procedures,” Dr. Meyer noted.

However, he said that a direct comparison study may be necessary to compare this procedure with trapeziectomy and the more complex procedures, such as ligament reconstruction and tendon interposition.

SAN ANTONIO — Injections of a hyaluronic acid derivative provide a safer and more effective alternative to corticosteroids for nonoperative treatment of trapeziometacarpal arthritis, according to a report presented at a joint annual meeting of the American Society for Surgery of the Hand and American Society of Hand Therapists.

Long used to treat symptoms of knee osteoarthritis, injections of the hyaluronic acid derivative Synvisc (hylan) were compared with injections of corticosteroid and placebo for basal-joint arthritis in a study led by Melvin P. Rosenwasser, M.D., and associates from Columbia University Medical School, New York.

Sixty patients with basal-joint arthritis were randomized to three groups: two intraarticular injections of Synvisc at weekly intervals, one placebo injection followed by one corticosteroid injection 1 week later, or two saline injections 1 week apart.

Patients were evaluated at 2 weeks, 1 month, 3 months, and 6 months and were assessed using patient satisfaction surveys, including the visual analog scores for pain (VAS); disabilities of the arm, shoulder, and hand (DASH) scores; and physical examinations testing thumb range of motion (ROM), grip strength, and pinch strength.

The majority of patients were postmenopausal women, with an average age of 63 years, and the dominant hand was affected. VAS results showed statistically significant improvement in the placebo and steroid groups at 1 month, but not at 6 months, compared with baseline. Significant pain relief in the hylan group occurred at 6 months, but not at 1 month.

At 1-month follow up, symptoms had improved in 50% of the placebo group, 68% of the steroid group, and 44% of the hylan group.

At 6 months, symptoms had improved by 68% in the hylan group, 58% in the steroid group, and 47% in the placebo group.

Benefits with regard to pain, grip and pinch strength, and range of motion were similar in all three groups until the 26th week, when hylan's benefits appeared more significant, said Dr. Rosenwasser, noting there were no adverse effects from treatment in any of the groups.

SAN ANTONIO — Injections of a hyaluronic acid derivative provide a safer and more effective alternative to corticosteroids for nonoperative treatment of trapeziometacarpal arthritis, according to a report presented at a joint annual meeting of the American Society for Surgery of the Hand and American Society of Hand Therapists.

Long used to treat symptoms of knee osteoarthritis, injections of the hyaluronic acid derivative Synvisc (hylan) were compared with injections of corticosteroid and placebo for basal-joint arthritis in a study led by Melvin P. Rosenwasser, M.D., and associates from Columbia University Medical School, New York.

Sixty patients with basal-joint arthritis were randomized to three groups: two intraarticular injections of Synvisc at weekly intervals, one placebo injection followed by one corticosteroid injection 1 week later, or two saline injections 1 week apart.

Patients were evaluated at 2 weeks, 1 month, 3 months, and 6 months and were assessed using patient satisfaction surveys, including the visual analog scores for pain (VAS); disabilities of the arm, shoulder, and hand (DASH) scores; and physical examinations testing thumb range of motion (ROM), grip strength, and pinch strength.

The majority of patients were postmenopausal women, with an average age of 63 years, and the dominant hand was affected. VAS results showed statistically significant improvement in the placebo and steroid groups at 1 month, but not at 6 months, compared with baseline. Significant pain relief in the hylan group occurred at 6 months, but not at 1 month.

At 1-month follow up, symptoms had improved in 50% of the placebo group, 68% of the steroid group, and 44% of the hylan group.

At 6 months, symptoms had improved by 68% in the hylan group, 58% in the steroid group, and 47% in the placebo group.

Benefits with regard to pain, grip and pinch strength, and range of motion were similar in all three groups until the 26th week, when hylan's benefits appeared more significant, said Dr. Rosenwasser, noting there were no adverse effects from treatment in any of the groups.

SAN ANTONIO — Injections of a hyaluronic acid derivative provide a safer and more effective alternative to corticosteroids for nonoperative treatment of trapeziometacarpal arthritis, according to a report presented at a joint annual meeting of the American Society for Surgery of the Hand and American Society of Hand Therapists.

Long used to treat symptoms of knee osteoarthritis, injections of the hyaluronic acid derivative Synvisc (hylan) were compared with injections of corticosteroid and placebo for basal-joint arthritis in a study led by Melvin P. Rosenwasser, M.D., and associates from Columbia University Medical School, New York.

Sixty patients with basal-joint arthritis were randomized to three groups: two intraarticular injections of Synvisc at weekly intervals, one placebo injection followed by one corticosteroid injection 1 week later, or two saline injections 1 week apart.

Patients were evaluated at 2 weeks, 1 month, 3 months, and 6 months and were assessed using patient satisfaction surveys, including the visual analog scores for pain (VAS); disabilities of the arm, shoulder, and hand (DASH) scores; and physical examinations testing thumb range of motion (ROM), grip strength, and pinch strength.

The majority of patients were postmenopausal women, with an average age of 63 years, and the dominant hand was affected. VAS results showed statistically significant improvement in the placebo and steroid groups at 1 month, but not at 6 months, compared with baseline. Significant pain relief in the hylan group occurred at 6 months, but not at 1 month.

At 1-month follow up, symptoms had improved in 50% of the placebo group, 68% of the steroid group, and 44% of the hylan group.

At 6 months, symptoms had improved by 68% in the hylan group, 58% in the steroid group, and 47% in the placebo group.

Benefits with regard to pain, grip and pinch strength, and range of motion were similar in all three groups until the 26th week, when hylan's benefits appeared more significant, said Dr. Rosenwasser, noting there were no adverse effects from treatment in any of the groups.