Trapezio-metacarpal osteoarthritis is a common condition for which the reference standard treatment after failure of non-operative measures is trapeziectomy. Several techniques have been devised to avoid proximal migration of the first metacarpal bone (M1) with impingement on the scaphoid bone. We have developed a Gore-Tex® ligament reconstruction technique that avoids potential complications of tendon harvesting. The objective of this study was to assess the long-term outcomes of this technique. Trapeziectomy with Gore-Tex® ligament reconstruction is a reliable option for providing lasting pain relief in patients with trapezio-metacarpal osteoarthritis. We conducted an observational, single-centre, single-surgeon, retrospective cohort study in consecutive patients managed by primary trapeziectomy. We excluded patients with revision trapeziectomy or less than 10 years’ follow-up. The primary outcome was event-free survival, defined as absence of revision surgery and of a numerical rating scale score for pain above 3/10. The secondary criteria were clinical tolerance of the Gore-Tex® implant and radiological changes. The patients were assessed at last follow-up either in person or during a teleconsultation. Of 78 included joints, 54 were assessed during patient visits and 24 by teleconsultation. At 10 years, the event-free survival rate was 91.3%, and 60.3% of patients were free of pain. Evidence of osteolysis was visible in 24% of patients. No patient experienced clinical intolerance of the Gore-Tex® implant. The mean Disabilities of Arm, Shoulder and Hand score was 25.5. Metacarpo-phalangeal hyperextension was significantly increased, to 30.6°, and the mean trapezial space ratio was significantly decreased, to 39.1% of the baseline value. Long-term event-free survival was high. Functional outcomes and pain were similar to previous reports. Trapeziectomy with Gore-Tex® ligament reconstruction obviates the need for tendon harvesting. Osteolysis developed in some patients but did not correlate with clinical intolerance. Long-term clinical and radiological monitoring is in order after Gore-Tex® implantation. IV, Observational, single-centre, single-surgeon, retrospective cohort study.

中文翻译：

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斜方肌切除术联合 Gore-Tex® 韧带重建治疗斜方掌骨骨关节炎的长期结果

斜方掌骨骨关节炎是一种常见病症，非手术治疗失败后的参考标准治疗方法是斜方肌切除术。已经设计了几种技术来避免第一掌骨（M1）近端迁移并撞击舟状骨。我们开发了一种 Gore-Tex® 韧带重建技术，可以避免肌腱切除的潜在并发症。本研究的目的是评估该技术的长期结果。梯形切除术结合 Gore-Tex® 韧带重建是为斜方掌骨骨关节炎患者提供持久疼痛缓解的可靠选择。我们对接受原发性梯形切除术的连续患者进行了一项观察性、单中心、单外科医生的回顾性队列研究。我们排除了接受修正梯形切除术或随访时间少于 10 年的患者。主要结局是无事件生存期，定义为没有进行翻修手术且疼痛数字评定量表评分高于 3/10。次要标准是 Gore-Tex® 植入物的临床耐受性和放射学变化。在最后一次随访时，亲自或在远程会诊期间对患者进行了评估。在 78 个关节中，54 个在患者就诊期间进行了评估，24 个通过远程会诊进行了评估。 10 年时，无事件生存率为 91.3%，60.3% 的患者没有疼痛。 24% 的患者出现骨质溶解的迹象。没有患者对 Gore-Tex® 植入物产生临床不耐受。手臂、肩部和手部残疾的平均得分为 25.5。掌指过度伸展显着增加，达到 30.6°，平均梯形间隙比显着降低，达到基线值的 39.1%。长期无事件生存率很高。功能结果和疼痛与之前的报告相似。采用 Gore-Tex® 韧带重建的梯形切除术无需切除肌腱。一些患者出现骨溶解，但与临床不耐受无关。 Gore-Tex® 植入后需要进行长期临床和放射学监测。 IV，观察性、单中心、单外科医生、回顾性队列研究。