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Basal joint arthroplasty and carpal tunnel release comparing a single versus double incision: a prospective randomized study

Abstract

Purpose

Basal thumb joint osteoarthritis frequently coexists with carpal tunnel syndrome. The two conditions have traditionally been treated surgically through separate incisions. We sought to determine whether carpal tunnel release using a single incision during basal joint arthroplasty is as effective as a two-incision approach in patients with concomitant carpal tunnel syndrome and basal thumb joint osteoarthritis.

Methods

For this purpose, 40 patients were randomly allocated to either a single-incision or double-incision approach, all of whom completed the full follow-up period. The Boston Carpal Tunnel Questionnaire, QuickDASH, and a 10-point visual analog scale pain-severity rating were obtained from patients 3, 6 and 12 months post-operatively.

Results

The two treatment groups experienced comparable, progressive improvement in all symptom-, function-, and pain-related outcomes, with mean surgery time significantly shorter with the single-incision approach, and four versus zero patients in the double-incision group developing pillar pain (p = 0.035).

Conclusions

Concomitant basal thumb joint osteoarthritis and carpal tunnel syndrome might be effectively performed through a single-incision approach, potentially avoiding any morbidity classically associated with a second incision.

Level of evidence

Level II/Therapeutic Study.

Trial registration

ClinicalTrials.gov: NCT04391751, 04/29/2020, retrospectively registered.

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Funding

The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors

Contributions

IE-F and IG-C researched literature and conceived the study. ALL-B was involved in protocol development and NV in gaining ethical approval. SB-O and XM were involved in patient recruitment and data analysis. IE-F and IG-C wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Irene Gallardo-Calero.

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The authors have no relevant financial or non-financial interests to disclose. The authors have no conflicts of interest to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.

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Ethics approval

Ethical approval for this study was obtained from COMITÉ DE ÉTICA DE INVESTIGACIÓN CLÍNICA (CEIC) DEL HOSPITAL UNIVERSITARI VALL D’HEBRON (PR(ATR)147/2018).

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Informed consent to participate was obtained from all individuals participants included in the study.

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Informed consent for publication was obtained from all individuals participants included in the study.

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Esteban-Feliu, I., Gallardo-Calero, I., Barrera-Ochoa, S. et al. Basal joint arthroplasty and carpal tunnel release comparing a single versus double incision: a prospective randomized study. Eur J Orthop Surg Traumatol (2021). https://doi.org/10.1007/s00590-021-03086-x

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Keywords

  • Basal joint arthroplasty
  • Carpal tunnel release
  • Single approach
  • Double approach