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Several surgical techniques to treat thumb basal joint arthritis have been described. In this study we compared the results of a cemented thumb basal joint with trapeziectomy with a ligament reconstruction and tendon interposition. A questionnaire was sent to all 519 patients, 322 (with 382 procedures) responded. No significant differences were found when comparing impairment, pain, patient satisfaction and disability. Given the fact that the superiority of a prosthesis cannot be proven and the cost of the implant is greater, we recommend the trapeziectomy with ligament reconstruction and tendon interposition as opposed to arthroplasty as the first choice in the treatment of basal joint osteoarthritis of the thumb. [ABSTRACT FROM PUBLISHER]

Several surgical techniques to treat thumb basal joint arthritis have been described. In this study we compared the results of a cemented thumb basal joint with trapeziectomy with a ligament reconstruction and tendon interposition. A questionnaire was sent to all 519 patients, 322 (with 382 procedures) responded. No significant differences were found when comparing impairment, pain, patient satisfaction and disability. Given the fact that the superiority of a prosthesis cannot be proven and the cost of the implant is greater, we recommend the trapeziectomy with ligament reconstruction and tendon interposition as opposed to arthroplasty as the first choice in the treatment of basal joint osteoarthritis of the thumb.

The effect of correction of metacarpophalangeal (MCP) joint hyperextension on the outcome of reconstructive surgery for basal joint osteoarthritis of the thumb was studied. Impairment, pain and satisfaction were similar after a combined surgical treatment of MCP hyperextension and basal thumb osteoarthritis in 33 patients, as in a series of 233 patients at the same institution after osteoarthritis surgery with a normal MCP joint.

The outcome of ulnar shortenings was compared to the outcome after arthroscopic wafer resections for ulnar impaction (or abutment) syndrome in patients with a positive ulnar variance. Both surgical techniques are described. The outcome was measured by the DASH score, the visual analogue score for pain and the working incapacity. The mean DASH score in the ulnar shortening group was 26, in the wafer group it was 36. The VAS were respectively 4.4 and 4.6. The working incapacity was 7 months in the ulnar shortening group and 6.1 months in the wafer group. The differences between the two groups were not statistically significant.

We retrospectively assessed time off work after rotator cuff repair, in relation with the compensation system and the shoulder loading demand at work. The Belgian insurance system distinghuises three main financial compensation systems for time off work. Patients with a work-related accident receive the highest compensation. A second group includes employees suffering a private accident or a chronic rotator cuff tear. Self-employed workers receive the lowest compensation. Work-demand on the shoulder was graded level I to IV according to the Iannotti classification. From a series of 201 young patients who underwent rotator cuff tear surgery, 93 were selected based on specific inclusion criteria; of these 93 patients, 73 could be thoroughly investigated. We found a significantly longer postoperative time off work in the highest compensation group (7 months versus 2.5 months for the lowest compensation group). We found a significantly longer postoperative time to return to work in the higher stages of the Iannoti classification. Based on the results of this study, the probable postoperative absence from work can be roughly estimated for each patient after rotator cuff surgery in relation with the particular compensation system and particular occupational demand level.