Leila Khorashadi MD, Presenter: Nothing to Disclose

Alice S. Ha MD, Abstract Co-Author: Nothing to Disclose

Felix Sze-Kway Chew MD, Abstract Co-Author: Nothing to Disclose

Arthroplasty at the first carpometacarpal joint as treatment for debilitating arthritis has become the most common operation for osteoarthritis involving the hand. The goal is to preserve motion, reduce subluxation, instability and pain. Our purpose is to explain the radiologic features of the surgical approaches and review potential complications.  

Improved surgical technology and better understanding of the biomechanics of this complex joint have led to development of new operations to treat cases refractory to conservative therapy. This can be achieved with either a combination of trapeziectomy with ligament reconstruction and interposition of costochondral allograft or trapeziectomy and silicone versus tendon interposition. We will show the evolution of the surgically altered first CMC joint over time, and review possible complications.  

Pre-operative imaging aims to evaluate the degree of the first basal joint osteoarthritis. Post-operative imaging focuses on detecting complications including subluxation and proximal metacarpal migration, allograft fracture, synovitis or scapho-trapezium-trapezoid joint osteoarthritis. Understanding various arthroplasty techniques and corresponding radiologic appearances will be essential for radiologists to be able to detect complications.

Khorashadi, L, Ha, A, Chew, F, Thumbs Up: The Radiologist's Guide to the Galaxy of First Carpometacarpal (CMC) Joint Arthroplasty.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012407.html