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Plast Reconstr Surg. 2017 Aug;140(2):327-335. doi: 10.1097/PRS.0000000000003510.

Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Study.

Author information

1
Hameln, Leverkusen, and Oldenburg, Germany From the Department of Plastic, Aesthetic Surgery, and Hand Surgery, Sana Klinikum Hameln Pyrmont; Plastic and Aesthetic Surgery, Department of Orthopaedic, Trauma, Hand, and Reconstructive Surgery, Klinikum Leverkusen; and the Klinik für Kinder- und Jugendpsychiatrie/Psychosomatik und Psychotherapie, Klinikum Oldenburg.

Abstract

BACKGROUND:

Most operations for carpometacarpal joint osteoarthritis of the thumb irreversibly alter or destroy the anatomy. There is a high demand for minimally invasive alternatives. The authors report the results of autologous fat transfer for treatment of thumb carpometacarpal joint osteoarthritis.

METHODS:

In a prospective study, 50 patients with thumb carpometacarpal joint osteoarthritis were observed for 1 year after autologous fat transfer. Manual liposuction and centrifugation were performed. Pain rating according to visual analogue pain scale; objective force of pinch grip and fist closure; and Disabilities of the Arm, Shoulder, and Hand questionnaire scores before and after treatment were analyzed.

RESULTS:

The average pain in stage 2 patients preoperatively was 7.7 ± 1.3; it was 1.8 ± 1.9 after 6 months and 2.4 ± 3.1 after 12 months. Patients with stage 2 osteoarthritis demonstrated a superior benefit from this treatment compared with patients with either stage 3 or stage 4 thumb carpometacarpal joint osteoarthritis. There were similar improvements for the parameters strength and Disabilities of the Arm, Shoulder, and Hand questionnaire score. No serious adverse events were observed.

CONCLUSIONS:

Autologous fat transplantation is an appealing alternative, especially in early-stage basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients compared with classical procedures such as trapeziectomy, and the superior long-term results compared with classical injection therapy, make this approach feasible as a first-line therapy in early-stage basal joint osteoarthritis of the thumb.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.

PMID:
28369017
DOI:
10.1097/PRS.0000000000003510
[Indexed for MEDLINE]

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