Thumb disfigurement from artelon spacer

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Aetna considers the following metacarpophalangeal MCP or proximal interphalangeal PIP joint implants medically necessary for members with symptomatic rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, or post-traumatic arthritis when conservative medical management fails to relieve pain or when digit deformity is interfering with hand function and activities of daily living:. Aetna considers resurfacing arthroplasty of the PIP joint experimental and investigational in the treatment of osteoarthritis and all other indications. When conservative medical management fails to relieve pain or when digit deformity is interfering with hand function and activities of daily living, surgical interventions are considered.

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Increases in procedure incidence were noted in all regions of the United States, but the largest percentage increase occurred in the Northeast. Despite this increase, the Northeast also had significantly lower CMC interposition arthroplasty incidence compared with all other regions and with the average procedure incidence throughout the study period—demonstrating some regional bias as to treatment of thumb CMC-OA. Unfortunately, because of database limitations and lack of specific CPT codes for other treatment options for thumb CMC-OA, we cannot ascertain if other types of surgery are more frequently used in the Northeast. Our study demonstrated that, compared with CMC interposition arthroplasties, significantly fewer thumb CMC arthrodesis procedures were performed in the same Medicare population during the same period.

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Silastic metacarpophalangeal arthroplasty SMPA has proven to be a durable option for end-stage arthritis in the non-thumb digits, while fusion has been the mainstay procedure for the thumb metacarpophalangeal joint MP. Few studies exist to comment on the viability of thumb MP arthroplasty. This study reports both survival and objective outcomes following SMPA of the thumb.

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Complications with the use of the Artelon spacer in thumb carpometacarpal CMC joint arthritis include inflammation, osteolysis, and persistent pain. We evaluated our short-term results and complications. A retrospective review of 29 patients was performed.

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Small joints replacement is a valid treatment for moderate to severe osteoarthritis of the hand. Several design and materials are now available for prostethic procedures with very different clinical and functional outcomes. An online search was carried out using Medline, Cochrane and Google scholar online databases, searching for studies on small joints replacement in hand surgery. Good functional and clinical outcomes can be achieved with silicone and pyrolitic carbon implants, either for trapeziometacarpal and metacarpophalangeal joints.

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We conducted a study to investigate current trends in carpometacarpal CMC interposition arthroplasty across time, sex, age, and region of the United States; per-patient charges and reimbursements; and the association between this procedure and concomitantly performed carpal tunnel syndrome CTS and carpal tunnel release CTR. Between andthe number of patients who had CMC interposition arthroplasty increased Females had the procedure more frequently than males at all time points, though the percentage of patients who were male increased throughout the study period.

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