Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. Prosthesis

<b>Background</b>: Trapeziometacarpal (TM) joint arthritis is a common condition causing pain and functional limitations, particularly in activities requiring pinch and grip strength. Surgical options such as interposition trapeziectomy and prosthetic joint replacement have demonstrated...

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Main Authors: Camillo Fulchignoni, Silvia Pietramala, Leopoldo Arioli, Emanuele Gerace, Domenico De Mauro, Giulia Frittella, Elisa Di Dio, Mirko Grauso, Gianfranco Merendi, Lorenzo Rocchi
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Journal of Functional Morphology and Kinesiology
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Online Access:https://www.mdpi.com/2411-5142/10/2/198
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author Camillo Fulchignoni
Silvia Pietramala
Leopoldo Arioli
Emanuele Gerace
Domenico De Mauro
Giulia Frittella
Elisa Di Dio
Mirko Grauso
Gianfranco Merendi
Lorenzo Rocchi
author_facet Camillo Fulchignoni
Silvia Pietramala
Leopoldo Arioli
Emanuele Gerace
Domenico De Mauro
Giulia Frittella
Elisa Di Dio
Mirko Grauso
Gianfranco Merendi
Lorenzo Rocchi
author_sort Camillo Fulchignoni
collection DOAJ
description <b>Background</b>: Trapeziometacarpal (TM) joint arthritis is a common condition causing pain and functional limitations, particularly in activities requiring pinch and grip strength. Surgical options such as interposition trapeziectomy and prosthetic joint replacement have demonstrated varying degrees of success. However, the role of post-operative rehabilitation in optimizing outcomes for these procedures remains underexplored. Effective rehabilitation may be critical for restoring strength, range of motion (ROM), and overall hand function; yet, no consensus exists on the best approach for either surgical modality. This study aims to evaluate the impact of post-operative rehabilitation on functional and clinical outcomes in patients undergoing interposition trapeziectomy versus prosthetic replacement for TM joint arthritis. <b>Methods</b>: A retrospective cohort study was conducted on patients treated for TM joint arthritis between November 2023 and October 2024. Patients were divided into two groups based on the surgical procedure: interposition trapeziectomy and prosthetic replacement. Patients randomly followed post-operative rehabilitation protocols, auto-assisted exercises, or no type of rehabilitation. The outcomes assessed included pain (VAS), return to work or heavy activities, post-operative complications, hand function (DASH score), and patient satisfaction at 1 and 6 months after surgery. <b>Results</b>: The prosthesis group consisted of 30 patients, while 31 patients underwent interposition trapeziectomy. Patients in both groups showed good improvements in pain, ROM, and hand function post rehabilitation. The prosthetic group demonstrated a faster recovery of strength and higher early satisfaction scores, but in the long term, the results were overlapping. No significant differences were observed in long-term functional outcomes or patient satisfaction at 6 months. In the trapeziectomy group, for patients who followed a rehabilitation program, no significant differences were found. <b>Conclusions</b>: Post-operative rehabilitation finds its place in recovery after both interposition trapeziectomy and prosthetic replacement for TM joint arthritis. While prosthetic replacement allows for quicker functional recovery, interposition trapeziectomy offers comparable long-term results with a lower complication profile. Tailored rehabilitation protocols may enhance outcomes and should be considered an integral part of TM joint arthritis management in selected patients.
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spelling doaj-art-5e15858d53ff4d18b6c85634d4fde7532025-08-20T03:27:29ZengMDPI AGJournal of Functional Morphology and Kinesiology2411-51422025-05-0110219810.3390/jfmk10020198Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. ProsthesisCamillo Fulchignoni0Silvia Pietramala1Leopoldo Arioli2Emanuele Gerace3Domenico De Mauro4Giulia Frittella5Elisa Di Dio6Mirko Grauso7Gianfranco Merendi8Lorenzo Rocchi9Orthopaedics and Hand Surgery Unit, Fondazione Policlinico A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Orthopaedics, Aeging and Rheumatology Sciences, Fondazione Policlinico A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, ItalyOrthopaedics and Hand Surgery Unit, Fondazione Policlinico A. Gemelli IRCCS, 00168 Rome, ItalyOrthopaedics and Hand Surgery Unit, Fondazione Policlinico A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Orthopaedics, Aeging and Rheumatology Sciences, Fondazione Policlinico A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDepartment of Orthopaedics, Aeging and Rheumatology Sciences, Fondazione Policlinico A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDepartment of Orthopaedics, Aeging and Rheumatology Sciences, Fondazione Policlinico A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDepartment of Orthopaedics, Aeging and Rheumatology Sciences, Fondazione Policlinico A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, ItalyOrthopaedics and Hand Surgery Unit, Fondazione Policlinico A. Gemelli IRCCS, 00168 Rome, ItalyOrthopaedics and Hand Surgery Unit, Fondazione Policlinico A. Gemelli IRCCS, 00168 Rome, Italy<b>Background</b>: Trapeziometacarpal (TM) joint arthritis is a common condition causing pain and functional limitations, particularly in activities requiring pinch and grip strength. Surgical options such as interposition trapeziectomy and prosthetic joint replacement have demonstrated varying degrees of success. However, the role of post-operative rehabilitation in optimizing outcomes for these procedures remains underexplored. Effective rehabilitation may be critical for restoring strength, range of motion (ROM), and overall hand function; yet, no consensus exists on the best approach for either surgical modality. This study aims to evaluate the impact of post-operative rehabilitation on functional and clinical outcomes in patients undergoing interposition trapeziectomy versus prosthetic replacement for TM joint arthritis. <b>Methods</b>: A retrospective cohort study was conducted on patients treated for TM joint arthritis between November 2023 and October 2024. Patients were divided into two groups based on the surgical procedure: interposition trapeziectomy and prosthetic replacement. Patients randomly followed post-operative rehabilitation protocols, auto-assisted exercises, or no type of rehabilitation. The outcomes assessed included pain (VAS), return to work or heavy activities, post-operative complications, hand function (DASH score), and patient satisfaction at 1 and 6 months after surgery. <b>Results</b>: The prosthesis group consisted of 30 patients, while 31 patients underwent interposition trapeziectomy. Patients in both groups showed good improvements in pain, ROM, and hand function post rehabilitation. The prosthetic group demonstrated a faster recovery of strength and higher early satisfaction scores, but in the long term, the results were overlapping. No significant differences were observed in long-term functional outcomes or patient satisfaction at 6 months. In the trapeziectomy group, for patients who followed a rehabilitation program, no significant differences were found. <b>Conclusions</b>: Post-operative rehabilitation finds its place in recovery after both interposition trapeziectomy and prosthetic replacement for TM joint arthritis. While prosthetic replacement allows for quicker functional recovery, interposition trapeziectomy offers comparable long-term results with a lower complication profile. Tailored rehabilitation protocols may enhance outcomes and should be considered an integral part of TM joint arthritis management in selected patients.https://www.mdpi.com/2411-5142/10/2/198trapeziometacarpal osteoarthritisrehabilitationTMC prosthesis
spellingShingle Camillo Fulchignoni
Silvia Pietramala
Leopoldo Arioli
Emanuele Gerace
Domenico De Mauro
Giulia Frittella
Elisa Di Dio
Mirko Grauso
Gianfranco Merendi
Lorenzo Rocchi
Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. Prosthesis
Journal of Functional Morphology and Kinesiology
trapeziometacarpal osteoarthritis
rehabilitation
TMC prosthesis
title Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. Prosthesis
title_full Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. Prosthesis
title_fullStr Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. Prosthesis
title_full_unstemmed Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. Prosthesis
title_short Role of Post-Operative Rehabilitation in TM Joint Arthritis: Functional Outcomes of Interposition Trapeziectomy vs. Prosthesis
title_sort role of post operative rehabilitation in tm joint arthritis functional outcomes of interposition trapeziectomy vs prosthesis
topic trapeziometacarpal osteoarthritis
rehabilitation
TMC prosthesis
url https://www.mdpi.com/2411-5142/10/2/198
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