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Journal of Hand Surgery (British and European Volume)
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Articles

Swanson versus Apl Arthroplasty in the Treatment of Osteoarthritis of the Trapeziometacarpal Joint: a Prospective and Randomized Study in 26 Patients

M. TÄGIL
P. KOPYLOV

From the Hand Surgery Unit, Department of Orthopaedics, Lund University Hospital, S-221 85 Lund, Sweden

Correspondence: Dr Magnus Tägil, Hand Surgery Unit, Department of Orthopaedics, Lund University Hospital, S-221 85, Lund, Sweden. Tel.: +46-46-171501; Fax: +46-46-130752; E-mail: magnus.tagil{at}ort.lu.se

Twenty-six patients were operated because of osteo-arthritis of the trapeziometacarpal joint. After excision of the trapezium, they were randomized to receive either a Swanson silicone trapezium implant or a tendon interposition arthroplasty using a strip of the abductor pollicis longus tendon (APL). No infection or clinical silicone synovitis occurred and no major radiographic cyst formation was found. Two endoprostheses dislocated early. All 13 patients in the Swanson group and 11 of the 13 in the APL group were subjectively satisfied at 2–5 year (mean, 43 months) follow-up. All patients were free of pain at rest and at light work, but half of the patients in each group still experienced pain with heavy work. Thumb pinch strength and range of motion were not significantly different in the two groups. The trapezial space decreased both with load and length of follow-up in both groups. Five endoprostheses subluxed during stressed pinch.

In conclusion, both methods gave good, but not complete, pain relief and neither produced better results than the other in the short term.

Journal of Hand Surgery (British and European Volume), Vol. 27, No. 5, 452-456 (2002)
DOI: 10.1054/jhsb.2002.0836
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Home page
 J Hand Surg Eur VolHome page
T. R. C. DAVIS and A. PACE
Trapeziectomy for Trapeziometacarpal Joint Osteoarthritis: Is Ligament Reconstruction and Temporary Stabilisation of the Pseudarthrosis with a Kirschner Wire Important?
J Hand Surg Eur Vol., June 1, 2009; 34(3): 312 - 321.
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