• Paul E Zollinger, Maarten L Ellis, Halil Unal, and Wim E Tuinebreijer.
• Department of Orthopaedic Surgery, Ziekenhuis Rivierenland, Pres. Kennedylaan 1, 4002 WP Tiel, The Netherlands. PE.Zollinger@tiscali.nl
• Acta Orthop Belg. 2008 Jun 1; 74 (3): 317-22.

AbstractPatients with trapeziometacarpal joint arthritis stage II or III (according to Dell) and no benefit from non-operative therapy were selected to undergo joint arthroplasty. We performed 32 arthroplasties for first carpometacarpal arthritis in 27 patients using a cementless total trapeziometacarpal joint prosthesis. We undertook a prospective cohort study and evaluated the clinical results of total joint arthroplasty after an average of 39 months. Visual analogue scale (VAS) scores for pain, daily activities (ADL) and satisfaction were taken pre- and postoperatively, and the first web opening was measured. First web opening improved significantly as did pain, ADL and patient satisfaction. Surgery of arthritis of the first carpometacarpal joint can be complicated by complex regional pain syndrome (CRPS) type I. In all our patients Vitamin C 500 mg daily was started two days before surgery and continued during 50 days. There were no cases of CRPS under vitamin C prophylaxis. These results justify further investigation in a randomised clinical trial.

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