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RESULTS OF ARTHROSCOPIC DEBRIDEMENT FOR ISOLATED SCAPHO-TRAPEZIORAPEZOID ARTHRITIS

The Middlesex Hospital, Mortimer Street, London W1T 3AA

Symptomatic isolated scaphotrapeziotrapezoid joint arthritis affects approximately 10% of the population. Involvement of the scaphotrapeziotrapezoid (STT) joint occurs in 15–30% of all degenerate wrists. Investigation of the technique of arthroscopic debridement of this joint was undertaken to assess the symptom relief achieved and record any resulting postoperative morbidity which limits the success of other techniques used for this condition.

Ten consecutive patients with persistent symptoms were assessed prospectively by a research nurse. Measurements of range of motion and grip strength were obtained before and after surgery. Visual analogue scores for pain and satisfaction levels were also recorded and any limitation to activities of daily living was noted. Assessment included clinical examination for local tenderness over the STT joint.

Good or excellent subjective results were achieved in nine patients at final review at an average of 36 (12–65) months after arthroscopic debridement. One patient graded the result as fair due to failure to achieve normal range of motion. All patients described significant reduction in visual analogue pain scores from an average of 86.5 to 14.1 points. The Green and O’Brien wrist scores improved from a mean of 63.2 to 91.2 during the same time frame. Eight of the patients were in employment and returned to work at 3 months post-surgery without the use of any external splints. The wrist scores were maintained in the five patients reviewed at least three years post-operation.

Conclusion: Arthroscopic debridement is simple, safe and effective when compared with other treatment modalities, achieving excellent pain relief and restoration in function in the short term in patients with isolated idiopathic STT arthritis. Longer term follow-up is no doubt required.

The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom