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Saturday, October 9, 2010, 16:00-16:50Session B22: Arthroplasty- Getting it Right!Total Joint Replacement (De La Caffinire) in Steoarthritis ofTrapeziometacarpal Joint Technique and Results*Khalaf Moussa - Westpfalz Teaching Hospital - Kusel, Germany*Email: kmoussa@gmx.deBackground: The trapeziometacorpal joint (TMJ) of the thumb is a common site of primaryosteoarthritis. Pain, crepitis and instability secondary to subluxation are common symptomsassociated with TMJ arthritis. Conservative therapy help to control symptoms however withtime, many patients progress with pain, deformity and functional limitation. The goals ofoperative intervention are to restore stability and strength, decrease pain and to provide afunctional range of motion. Francobal-prosthesis may fulfil these criterions.Technique: We implanted the prosthesis through a dorso-radial straight longitudinal or slightlycurved skin incision. A dorsal capsulotomy is performed and at this step adduction deformityshould be addressed. An osteotomy of the proximal surface of the first metacarpal is madeperpendicular to the long axis of the medullary cavity followed by reaming of the medullarycavity and then a trial fit. This is followed by preparation of the trapezium including removingany osteophytes, drilling of a cavity. Dental burs may be used at this step to deepen the cavity.The process of cementation started by cementation of the cup with its opening neutral to thejoint surface, and if there is any muscle tension, bone is removed from the metacarpal beforethe metacarpal component is cemented. Reduction is achieved by snapping. The capsule andwound are closed and the thumb is immobilised in an adduction splint for ten days.Results: Results showed marked improvement of pain in many patients with high rate ofsatisfaction. No restriction of movement or instability was observed. In some cases, loosening ofthe shaft was noticed. However, this does not affect the overall function.Discussion: De La Caffinière-prosthesis presents one of the operative options in themanagement of trapeziometacorpal joint (TMJ). Arthritis, however, this operation isrecommended only in selective cases where skaphoid-trapezium-trapezoid( STT) joints are notinvolved.Thursday, October 7, 2010, 8:30-9:20Session B2: Knee Arthroplasty in the Indian Sub ContinentEffect of Hindfoot Alignment on Mechanical Axis Deviation After TotalKnee Arthroplasty in Osteoarthritisfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]