New technique: AlloDerm® interposition arthroplasty of thumb carpo-metacarpal joint

Abstract

Excision arthroplasty is an alternative procedure for degenerative arthritis of the trapezium carpal bone that has failed non-surgical treatment. Autologous or heterologous interposition materials are used following excision of the trapezium, but may not prevent first metacarpal-scaphoid joint collapse or subsidence. AlloDerm^® is a cadaver-harvested, immunologically inert dermal collagen graft. This report documents the uncomplicated use of AlloDerm^® in 13 thumbs of 9 patients who had first carpometacarpal (CMC) joint excision interposition arthroplasty for degenerative arthritis. Joints functioned well after arthroplasty with AlloDerm^®. These clinical results compare favorably to results in 6 Silicon implant CMC arthroplasty patients, and 3 autologous dermal graft CMC arthroplasty patients.   Future clinical research, on joint stability, the durability of this collagen graft, newer dermal collagen substrates, and prevention of metacarpal subsidence, will determine the ultimate role of AlloDerm^® in interposition arthroplasty.