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Medical Article Analysis

992 words - 4 pages

I have chosen an article titled, “Long-term follow-up of trapeziectomy with abductor pollicis longus tendon interposition arthroplasty for osteoarthritis of the thumb carpometacarpal joint.” This article comes from the Journal of Orthopaedics, Volume 10, Issue 2, Pages 59-64, June 2013. The authors of this article are Erez Avisar, Michael Elvey, Ziv Wasrbrout, and Maurice Aghasi. The hypothesis of this article was that the participating patients with moderate to severe osteoarthritis of the thumb would receive higher quality long-term results after receiving a trapeziectomy with abductor pollicis longus (APL) interposition arthroplasty. The primary reason for this investigation is to try and determine the optimal treatment for carpometacarpal (CMC) arthritis care as well as to analyze the patient’s post-surgical well-being after a prolonged period of time, fifteen years in this case.
The article first introduced that CMC is the most common joint in the hand to become arthritic and is characterized by pain, weakness, and deformity all of which can lead to significant disability (Aghasi, M., et. al, 2013). The pathophysiology of the arthritis is deemed to derive from either: 1) human evolutionary adaptation which has sacrificed the stability of the CMC joint or 2) the weakening of the palmar beak ligament and destabilization of the saddle joint leading to degenerative alterations. Once conservative methods of treatment, such as hand therapy, splinting, and steroidal injections have been exhausted surgical intervention is taken. This particular surgery involves an incision 1cm distal to the base of the first metacarpal and continuing proximally over the CMC joint, through the snuff-box, and ending 2.5 cm proximal to the radial styloid. Next, the trapezium is exposed and excised and the radial tendon is dissected, rolled up, and used as a spacer in the CMC joint by being anchored to the flexor carpi radialis. This is done to enhance the metacarpal abduction of the pollex. (Aghasi, M., et. al., 2013). Since much of the CMC surgery evidence existed with only short-term post-operative data, this study seeks to establish the long-term benefits of having a trapeziectomy with APL interposition arthroplasty to alleviate CMC arthritis.
This study involved thirteen patient participants, fourteen of the original patients were lost to follow-up and two lost to death. The mean age of the participants was 72 years (56-82) and the mean time of clinical and radiographic assessment was 15 years postoperative. The techniques used to perform the experiments were clearly defined and consisted of every patient undergoing the same APL tendon arthroplasty by the same group of surgeons (the authors). The clinical and radiographic evaluations were set in place to determine if the physician’s hypothesis were to be accepted or rejected. These evaluations consisted of visual analog scale (VAS) pain scores of both hands and The Disabilities of the Arm, Shoulder and Hand...

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