Interposition arthroplasty for the treatment of primary osteoarthritis: comparison of results using the technique of Epping and Weilby

We compare clinically and radiologically two groups of total trapezectomy performed as treatment for the primary osteoarthritis of trapeziometacarpal joint combined in 83 cases (2000 to 2003) with tendon interposition arthroplasty type Weilby, in 51 cases (1987 to 1991) with Epping tendon interposition and ligament reconstruction arthroplasty in a retrospective study. In both groups we used a strip of the flexor carpi radialis tendon. The mean follow-up time in both groups is 33 months. Overall, both methods achieved similar results. The relief of pain and the patient satisfaction are better, stability and grip force are worse in the Weilby group. At least one year (12 to 57 months) after operation with the technique of Weilby, 88 % of the patients would prefer this method for the other side. It appears that there is no clinical and radiological benefit of ligament reconstruction. However, the two procedures studied yield equally good results in most cases, but we prefer the simple technique of Weilby and guess that the (missing) long-term results would be superior to the results after trapezectomy alone. Long-term results need to be evaluated.