Manejo quirúrgico de la artrosis trapeciometacarpiana en estadios tempranos: Revisión sistematica de la literatura

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dc.contributor.advisorSandoval Reyes, Julio
dc.contributor.advisorRomero Barreto, Camilo
dc.contributor.advisorBaez, Martha
dc.contributor.authorTobar Bonilla, Walther Edilson
dc.contributor.authorLópez Acosta , David Santiago
dc.date.accessioned2024-08-01T20:27:45Z
dc.date.available2024-08-01T20:27:45Z
dc.date.issued2024-07
dc.description.abstractLa artrosis trapeciometacarpiana es una patología frecuente en la población mundial con mayor prevalencia en mujeres postmenopáusicas. No hay consenso respecto a cuál tratamiento es el más efectivo y cuál tratamiento retrasa o disminuye la progresión a largo plazo de la enfermedad y de los síntomas secundarios en los estadíos tempranos I, II y III Eaton-Littler. El objetivo de esta revisión sistemática de la literatura es determinar qué tratamientos quirúrgicos descritos en la literatura tienen un impacto positivo respecto a progresión del dolor y funcionalidad. El manejo de la artrosis trapeciometacarpiana sigue siendo controvertido con espacio de amplio debate. La denervación, reconstrucción ligamentaria y la osteotomía de extensión del primer metacarpiano son técnicas prometedoras para el manejo de la rizartrosis en etapas tempranas, sin embargo, requiere de más estudios multicéntricos de clase I y II que soporten conclusiones clínicamente aplicables con seguimiento a largo plazo. La artroscopia es una buena opción para los pacientes en estadio I y II ya que puede combinar otros procedimientos quirúrgicos. La artrodesis igual que la artroplastia con prótesis está muy controvertida en etapas iniciales y su utilidad es mayor en estadíos avanzados. Los implantes iniciales de interposición han entrado en desuso por importantes complicaciones, sin embargo, el implante de pyrocardan tiene estudios prometedores al igual que el uso de grasa autóloga en estadio I y aloinjerto de menisco en estadios II y III. Por último, los sistemas de tenosuspensión en combinación con artroscopia cada vez con mayor acogida con buenos resultados clínicos.
dc.description.abstractenglishTrapeziometacarpal osteoarthritis is a common pathology in the world population with a higher prevalence in postmenopausal women. There is no consensus regarding which treatment is the most effective and which treatment delays or decreases the long-term progression of the disease and secondary symptoms in early Eaton-Littler stages I, II and III. The objective of this systematic review of the literature is to determine which surgical treatments described in the literature have a positive impact regarding pain progression and functionality. The management of trapeziometacarpal osteoarthritis remains controversial with room for extensive debate. Denervation, ligamentous reconstruction and extension osteotomy of the first metacarpal are promising techniques for the management of rhizarthrosis in early stages; however, more multicenter class I and II studies are required to support clinically applicable conclusions with long-term follow-up. Arthroscopy is a good option for patients in stage I and II as it can combine other surgical procedures. Arthrodesis, like arthroplasty with a prosthesis, is very controversial in the initial stages and its usefulness is greater in advanced stages. Initial interposition implants have fallen into disuse due to important complications, however, the pyrocardan implant has promising studies, as does the use of autologous fat in stage I and meniscus allograft in stages II and III. Finally, tenosuspension systems in combination with arthroscopy are increasingly popular with good clinical results.
dc.description.degreelevelEspecializaciónspa
dc.description.degreenameEspecialista en Cirugía de Manospa
dc.format.mimetypeapplication/pdf
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/12787
dc.language.isoes
dc.publisher.facultyFacultad de Medicinaspa
dc.publisher.grantorUniversidad El Bosquespa
dc.publisher.programEspecialización en Cirugía de Manospa
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dc.relation.referencesOkita G, Anayama S, Sato N, Haro H.: Surgical reconstruction using suture anchor for dislocation of the carpometacarpal joint of the thumb: a case report. Arch Orthop Trauma Surg 2011; 131: pp. 225-228.
dc.relation.referencesI.C. Jongen, N.J. Nieuwdorp, C.A. Hundepool, F.S. Van Gelder, A.M. Schutter and J.M. Zuidam, Ligament reconstruction in thumb carpometacarpal joint instability: A systematic review, JPRAS Open, 2024-03-01, Volume 39, Pages 237-248, 2024 .
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dc.relation.referencesHonigmann P, Keller M, Devaux-Voumard N, Coppo E, Sutter D. Arch, Extension osteotomy of the metacarpal I and ligamentoplasty of the trapeziometacarpal joint for the treatment of early-stage osteoarthritis and instability of the trapeziometacarpal joint., Orthop Trauma Surg. 2023 Sep;143(9):6011-6018. doi: 10.1007/s00402-023-04883-1. Epub 2023 May 19.
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dc.rightsAtribución-NoComercial-CompartirIgual 4.0 Internacionalen
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.localAcceso abiertospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subjectRevisión sistemática
dc.subjectartrosis
dc.subjectArticulación
dc.subjectTrapeciometacarpiana
dc.subjectRizartrosis
dc.subjectOsteotomía
dc.subjectArtroscopia
dc.subjectDenervación
dc.subjectArtroplastia
dc.subjectReconstrucción ligamentaria
dc.subject.keywordsSystematic review
dc.subject.keywordsOsteoarthritis
dc.subject.keywordsTrapeziometacarpal joint
dc.subject.keywordsRhizarthrosis
dc.subject.keywordsOsteotomy
dc.subject.keywordsArthroscopy
dc.subject.keywordsDenervation
dc.subject.keywordsArthroplasty
dc.subject.keywordsLigament reconstruction.
dc.subject.keywordsJoint
dc.subject.nlmWE 830
dc.titleManejo quirúrgico de la artrosis trapeciometacarpiana en estadios tempranos: Revisión sistematica de la literatura
dc.title.translatedSurgical management of trapeziometacarpal osteoarthritis in early stages: Systematic review of the literature
dc.type.coarhttps://purl.org/coar/resource_type/c_7a1f
dc.type.coarversionhttps://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.driverinfo:eu-repo/semantics/bachelorThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesis/Trabajo de grado - Monografía - Especializaciónspa

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Especialización en Cirugía de Mano