Arthroscopic Trapeziectomy

Description

This video features a comprehensive demonstration of an arthroscopic trapeziectomy performed by Dr. Richard Tosti to treat basal joint arthritis of the thumb. The presentation begins with an overview of patient positioning and preparation, where the patient is placed in a supine position, and traction is applied to the thumb.



Using a specialized technique, Dr. Tosti makes an initial portal, places a 1.9mm arthroscope, and conducts a diagnostic examination of the joint. Observations reveal severe cartilage loss in the trapezium, prompting the need for surgical intervention. Subsequent steps involve creating a second portal and employing a burr tool to remove damaged bone while ensuring proper alignment with fluoroscopy for safe resection.



Throughout the procedure, Dr. Tosti emphasizes the importance of coordinated movements, using both arms and feet to control the equipment, and the necessity of tactile feedback to achieve an effective resection of about 85% of the trapezium. A thorough assessment of the area is conducted to ensure no remaining bone fragments, with particular attention to common spots where bone may adhere, such as around tendons and between the portals.



Post-operatively, patients can begin range of motion exercises within two weeks and strengthening exercises by six weeks, demonstrating quicker recovery and minimal scarring compared to traditional methods. The final segment is a comparative assessment of scarring between a conventional procedure and the featured arthroscopic technique, highlighting its advantages in terms of recovery and functionality.

Specialties