Allograft Meniscal Arthroplasty for the Treatment of Basal Joint Arthritis of the Thumb
Condition: Arthritis
MeSH terms: Arthritis
Study type: Observational

Summary: 
      Hypothesis:

      The use of knee meniscal allograft as a joint spacer and stabilizer is a viable option for
      the surgical treatment of basal joint arthritis of the thumb.

      A variety of surgical procedures have been developed for the treatment of basal joint
      osteoarthritis of the thumb. Problems with persistent pain and poor function have been
      reported to some degree for each of these procedures. Using the concept of an implant acting
      as a spacer and stabilizer the investigators proposed and implemented a novel surgical
      technique using allograft knee meniscus as a biologic implant for the treatment of basal
      joint arthritis of the thumb.
    

Detailed description: 
      Hypothesis:

      The use of knee meniscal allograft as a joint spacer and stabilizer is a viable option for
      the surgical treatment of basal joint arthritis of the thumb.

      Introduction:

      A variety of surgical procedures have been developed for the treatment of basal joint
      osteoarthritis of the thumb. Problems with persistent pain and poor function have been
      reported to some degree for each of these procedures. Promising results were originally
      reported (2004) for the Artelon carpometacarpal (CMC) implant (Small Bone Innovations,
      Morrisville, PA) procedure which utilized the concept of a spacer and stabilizer of the CMC
      joint . Recent studies however, have demonstrated problems due to a foreign body reaction
      with the Artelon implant requiring revision surgery. Using the concept of an implant acting
      as a spacer and stabilizer we proposed and implemented the use of allograft knee meniscus as
      a biologic implant in the treatment of basal joint arthritis of the thumb

      Methods:

      A prospective study was performed on four thumbs using an allograft knee meniscus
      transplanted into the thumb CMC joint using the surgical technique described for that of the
      Artelon implant (Small Bone Innovations, Morrisville, PA). Data collected included: pain
      level, grip strength, tip, key and pinch strength, carpometacarpal, metacarpophalangeal,
      interphalangeal, and oppositional range of motion, as well as Disabilities of the Arm,
      Shoulder, and Hand (DASH) scores. Interval radiographic analysis is to be performed.
      Endpoints for data collection will be at three months, six months, one, two, three, four, and
      five years follow up.
    

Intervention name(s): Meniscal allograft arthroplasty of the carpometacarpal joint of the thumb
Intervention type(s): Procedure
Intervention description(s): The surgical procedure will involve the use of human meniscal allograft tissue that will be provided by industry. The meniscus will be contoured into a "T" shape. The T-shaped meniscus allograft is then inserted into the arthritic thumb CMC joint and secured with two suture anchors.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Men and women of all ages having the diagnosis of osteoarthritis of the thumb.
      
Keywords: Allograft; Arthroplasty; Basal Joint; carpometacarpal joint; Thumb; meniscus; osteoarthritis; Patients with Stages I - III arthritis of the the thumb carpometacarpal joint