Surgical Treatment for Trapeziometacarpal Osteoarthritis Eaton & Glickel Stage 4

Trapeziectomy With Ligament Reconstruction and Tendon Interposition or Simple Trapeziectomy for Treating Trapeziometacarpal Osteoarthritis Eaton & Glickel Stage 4: a Randomized Clinical Trial

Trapeziometacarpal osteoarthritis is a common cause of pain and loss of hand function in postmenopausal women. Many surgical treatments have been described and recent literature has show that the relatively simple trapeziectomy gives equal results and less complications, when compared to other techniques such as ligament reconstructions and interpositions. These studies have been conducted predominantly in patients with stage 2 or 3 osteoarthritis. Stage 4 osteoarthritis is characterized by more cartilage and soft-tissue damage, which increases the chance for collapse of the first metacarpal bone and associated problems.

The investigators' hypothesis is that an LRTI can be of additional value in patients with stage 4 osteoarthritis.

Inclusion Criteria:

• Women
• 40 years of age or more
• Symptomatic trapeziometacarpal osteoarthritis
• Eaton & Glickel stage 4

Exclusion Criteria:

• An operation for trapeziometacarpal osteoarthritis on the same hand in the past.
• Participation in randomized clinical trial for trapeziometacarpal osteoarthritis with contralateral hand.
• Secondary trapeziometacarpal osteoarthritis as result of trauma, rheumatoid arthritis, systemic lupus or gout.
• Symptomatic carpal tunnel syndrome in same hand.
• Symptomatic Quervain's tenosynovitis in same hand.
• Neurological or other disorders of the affected side that can influence postoperative rehabilitation.
• Insufficient knowledge of Dutch language.