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Archive for August, 2015

CMC Arthritis Brace

August 25, 2015

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Historically basal joint arthritis or CMC arthritis has been treated with thumb splints that immobilizes the entire thumb.  In many cases these thumb braces extend down past the wrist.  These are big, bulky thumb splints whose primary purpose is to immobilize.

The Push brace Metagrip is a new alternative to treat CMC arthritis.  This is a low-profile and light weight design that utilizes dynamic stabilization.  During pinching when the CMC joint is being loaded, there is generally ligamentous laxity which allows the first metacarpal to move around.  This movement is what creates the thumb pain.  This CMC Arthritis Brace prevents that movement by stabilizing the CMC joint, not immobilizing it.

The Push Brace is made from pliable thermoplastic and is constructed with a moldable aluminum insert.  When the brace is first applied the insert needs to be squeezed around the thumb – that is the key to the brace.  Once applied the brace needs to be “broken in” like a new pair of shoes.  It may feel stiff at first but after the brace is worn for a while it will fit better.

This thumb splint is low profile enough that tasks which are difficult in a standard wrist and thumb brace can be easily accomplished:  play a musical instrument, drive a car, wear gloves, reach into your pocket….

 

 



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The Journal of Bone and Joint Surgery (JBJS) published findings that most patients with a torn or damaged meniscus (under 50 years old) experienced less knee pain and an increase in knee function following meniscal transplant surgery. Although, many patients required additional surgery within 10 years.

The meniscus acts as a cushion between the femur and tibial plateau. It can be damaged in an injury or slowly as the body ages.  A meniscus transplant can be performed in younger patients (under 50) to stabilize the knee joint, decrease knee pain, increase function, and maintain a cushion between the two bones.  The surgery is performed arthroscopically.

38 meniscal transplant patients under 50 years old were followed for about 11 years.  Outcomes were based on radiographic, subjective, and clinical measures.

10 years in to the research Sixty-three percent of meniscal transplants were still good.  11 percent of patients had pain when engaging in daily activities after the transplant. Also, nearly seventy-five percent of patients were able to participate in low-impact sports like swimming.  In patients requiring additional surgery, the meniscal transplants made it about  7 to 8 years after the surgery depending which knee compartment was being transplanted.

“This data provides surgeons with reasonable percentages that encourage delaying additional major knee surgeries related to a damaged meniscus,” Frank R. Noyes, MD, said.  Dr. Noyes is the lead author of the study and founder of the Noyes Knee Institute at the Cincinnati Sports Medicine & Orthopaedic Center.

“However, the longer-term function of meniscus transplants remains questionable because the survivorship rate of the transplants decreases to between 40 and 15 percent at 15 years,” Dr. Noyes commented. “Patients should be advised that this procedure is not curative in the long-term and additional surgery will most likely be necessary.”