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STT Arthritis

52 citationsUpdated Oct 2026
Illustration: hand

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

Scaphotrapeziotrapezoidal (STT) joint osteoarthritis is a common radiographic finding in hand clinic patients [1]. Clinical presentation may include carpal instability characterized by scaphoid extension and a normal scapholunate angle, distinct from radiographic scapholunate instability [5]. Because concomitant trapeziometacarpal arthritis and the limitations of radiographic evaluation obscure the true degree of degenerative change, intraoperative visualization of the STT joint is necessary to guide management [6]. Surgical options vary by clinical scenario: isolated cases are often managed by distal scaphoid resection or arthrodesis, while cases with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision [4]. Although numerous surgical options exist for STT osteoarthritis, none has clear evidence of superiority [30], and there is insufficient evidence to definitively support one approach over another for isolated disease [9]. Prospective randomized control trials are required to determine optimal treatment [11].

In all cases of isolated or associated STT osteoarthritis, maintaining scaphoid height via arthrodesis, resection of less than 3 mm, and/or associated interposition, along with oblique trapezoidal osteotomy to prevent scaphoid–metacarpal impingement, are crucial elements of surgical treatment [10]. For isolated idiopathic STT arthritis, fusion yields very satisfactory results with minimal complications [3]. Long-term outcomes of STT arthrodesis are encouraging, providing good range of motion, strength, and function, though achieving union requires strict adherence to surgical and postsurgical guidelines [8]. Staple fixation for isolated STT osteoarthritis significantly reduces pain and improves strength and functional scores [12]. At a mean follow-up of 10 years, STT arthrodesis carries a 10% risk of reoperation, which decreases with older patient age [18].

Excisional arthroplasty is highly recommended for idiopathic, symptomatic, isolated STT osteoarthritis without midcarpal instability, offering reliable results with less technical demand, shorter immobilization, and fewer complications than localized arthrodesis [22]. Open excision of the distal scaphoid pole is suitable for isolated STT arthritis without carpal malalignment due to its simplicity and lower complication rate [9]. Arthroscopic STT arthroplasty provides satisfactory pain relief and return of strength and function [15], with acceptable results also obtained via arthroscopic distal scaphoid resection [35]. Modified total trapezial, partial trapezoidal excision with ligament reconstruction tendon interposition is an effective alternative for isolated STT arthritis [14]. Distal scaphoidectomy with tendon interposition achieves good results with a relatively easy technique and shorter postoperative immobilization than arthrodesis [41]. Pyrocarbon implant application is confirmed by good results, simple procedure, and absence of complications, requiring no fixation or ligamentoplasty [56]. Surgical treatment of isolated STT osteoarthritis resistant to conservative management leads to significant functional improvement, particularly in pain, without altering overall wrist mobility [29].

Anatomy & Pathophysiology

Bony Anatomy & Kinematics

The hand and wrist skeleton comprises 27 bones, 19 of which are long bones [47]. The radial ray, or first ray, is the shortest column, consisting of a metacarpal and two phalanges [47]. This ray continues the external carpal column formed by the scaphoid and trapezium [47]. The trapezium is angled anteriorly relative to the carpal plane, creating an approximately 45-degree angle between the first and second metacarpals in the sagittal plane [47]. The thumb metacarpal is independent and articulates directly with the trapezium [66]. At the proximal level, the concavity of the trapeziotrapezoid joint matches the convexity of the distal scaphoid pole [96]. Scaphoid-trapezoid motion is rotational and obliquely oriented relative to the wrist sagittal plane, occurring in an ulnoflexion-radial extension plane during both flexion-extension and radial-ulnar deviation [83]. Thumb movements do not induce large STT rotations [19].

Ligaments & Stability

STT joint stabilization depends primarily on the scaphotrapezial ligament, which is thicker on its palmar face [96]. Two additional critical stabilizers are the dorsal capsular reinforcement of the STT ligament and the palmar radioscaphocapitate ligament [96]. Injuries to the scaphotrapezial ligament may progress toward osteoarthritis, and some cases of apparent primary STT osteoarthritis may be secondary to undetected post-traumatic ligament lesions [7]. An isolated scapholunate interosseous ligament injury is insufficient to cause DISI unless a secondary stabilizer, such as the dorsal intercarpal, dorsal radiocarpal, or STT ligamentous complex, is also involved [59]. Whether acute injury or time-dependent attenuation of these critical secondary stabilizers, in the absence of interosseous ligament injury, is sufficient to result in a lunate flexion or extension pattern remains unclear [59].

Vascular & Neural Relationships

The STT joint has close relationships with the radial artery, which passes anterior to the joint, and its dorsal branch, which crosses back over the scaphotrapezoid joint [96]. Terminal branches of the radial nerve also pass through the area of the STT joint [96].

Prevalence & Etiology

STT joint osteoarthritis is a common finding on hand radiographs of patients presenting to a hand clinic [1] and is often an incidental finding [39]. One report indicated a radiographic incidence of isolated STT arthritis of 9% [39]. Cadaveric studies demonstrate age-dependent prevalence: North and Eaton found STT arthritis in 16 of 68 cadaver wrists (average age 75 years) [39]; Viegas and colleagues reported an average incidence of 20% in 393 cadaver wrists (average age 67 years) [39]; and another study found evidence of STT arthritis in 83% of 73 wrists (average age 84 years) [39]. Despite this prevalence, STT OA accounts for only 13% of all wrist arthritis sites, and isolated lesions of the STT joint are rare [96]. An alteration in the normal biomechanics of the peritrapezial joint is thought to be the most common cause of STT arthritis, given the association between carpometacarpal and STT arthritis [39]. Arthritis secondary to trauma has been described for the STT joint [39]. Asymptomatic STT arthritis has also been noted after scaphoid screw placement for fracture through the distal pole of the scaphoid [39].

Pathophysiology & Associated Instability

An association between STT OA and static DISI has been described, with degenerative change at the STT joint occurring first and DISI following as a secondary phenomenon [13]. Another theory suggests that ligament laxity at the STT joint produces increased scaphoid mobility, resulting in OA and sometimes secondary DISI deformity [13]. In a study of radiographic characteristics associated with STT osteoarthritis, DISI was identified in 3 grade 2 wrists (5%) and 44 grade 3 wrists (60%) [26]. In a retrospective study of 24 wrists with STT OA and DISI, abnormal scaphoid extension was found in 79% of patients [59]. In the same cohort, the scapholunate angle was normal in all patients [59], while the capitolunate angle was abnormal in 50% [59]. Trapeziometacarpal OA was present in 67% of these patients, and midcarpal OA was found in 50% [59]. STT OA severity correlated with a higher capitolunate angle and occurred chronologically before trapeziometacarpal OA [59]. STT OA, as a stand-alone condition, may progress toward DISI rather than scapholunate dissociation leading to STT OA [59]. The presence of arthritis in two locations may explain persistent hand and wrist pain in patients with CMC arthritis despite CMC arthroplasty [44].

Classification

Radiographic Assessment and Prevalence

The uncertainty of radiographic evaluation for STT osteoarthritis and the prevalence of concomitant trapeziometacarpal and STT OA necessitate intraoperative visualization to determine the true degree of degenerative changes [6]. In surgically treated patients with CMC arthritis, a 31% incidence of end-stage ST joint arthritis was reported based on visual inspection [21]. A simple, reproducible technique for assessing the scaphotrapeziotrapezoid joint radiographically is described [40]. A specific radiographic view isolates the articular surfaces of the trapezoid and shows the whole joint, including good visualization of the trapeziotrapezoid and STT joints with the second metacarpal, free of most overlap [28].

Clinical Presentation and Diagnosis

Pain from STT OA is characteristically located on the radial side of the wrist, overlying the scaphoid tubercle volarly [25]. The character of STT OA pain may be sharp in nature, causing patients to drop things, compared to the characteristic ‘ache’ of CMC thumb joint pain [25]. The difficult initial diagnosis of STT ligament injury relies on clinical examination, standard and stress X-rays [7]. Midcarpal arthrography confirms the diagnosis of STT ligament injury, with leakage of contrast medium observed over the external part of the STT space [7]. In a cadaveric model, a dorsal approach was found to be the safest and most reproducible technique for injection of the scaphotrapezium-trapezoid joint without image guidance [23].

Association with Carpal Instability

An association between STT OA and static DISI has been described, with an assertion that degenerative change at the STT joint occurs first and DISI follows as a secondary phenomenon [13]. Another theory suggests that first ligament laxity at the STT joint produces increased scaphoid mobility, which results in OA and sometimes secondary DISI deformity [13]. The combination of STT osteoarthritis and static DISI was found in 16 wrists, which was statistically significant (0.02 < P < 0.05) [24]. In a study of radiographic characteristics of carpal instability associated with STT osteoarthritis, DISI was identified in 3 grade 2 wrists (5%), and 44 grade 3 wrists (60%) [26]. Some cases of apparent primary STT osteoarthritis may in fact be secondary to undetected post-traumatic ligament lesions [7]. An isolated SLIL injury is not sufficient to cause DISI unless a secondary stabilizer ligament, such as the dorsal intercarpal (DIC) ligament, dorsal radiocarpal (DRC) ligament, or the STT ligamentous complex, is also involved [59]. In a retrospective study of 24 wrists with STT OA and DISI, scaphoid extension was found in 79% of the patients [59]. In the same study, the scapholunate angle was normal in all patients [59], the capitolunate angle was abnormal in 50% of the patients [59], trapeziometacarpal OA was present in 67% of the patients [59], and midcarpal OA was found in 50% of the patients [59].

Classification Systems and Agreement

Eaton–Glickel: This classification is used to rate TMC and ST joint arthrosis [87]. Interobserver agreement of the radiographic Eaton–Glickel classification was assessed using the weighted s* statistic [87].

Clinical Presentation

Pain characteristics: Pain from STT arthritis is characteristically located on the radial side of the wrist, overlying the scaphoid tubercle volarly [25]. The pain is typically sharp in nature and may cause patients to drop things, distinguishing it from the characteristic ache of CMC thumb joint pain [25]. In contrast, CMC joint pain typically presents more dorsally and distally than STT arthritis pain [25].

Diagnostic accuracy and imaging: The true prevalence of scaphotrapezoid arthritis was 62% in thumbs undergoing trapezium excision arthroplasty, while the sensitivity of the radiographic diagnosis was 44% and the specificity was 86% [50]. SPECT/CT is able to differentiate between osteoarthritic pain arising from the trapeziometacarpal joint and the scaphotrapeziotrapezoid joint [53].

Associated instability: An association between STT osteoarthritis and static dorsal intercalated segment instability (DISI) was found in 16 wrists, which was statistically significant (0.02 < P < 0.05) [24].

Injection and immobilization: A dorsal approach was found to be the safest and most reproducible technique for injection of the scaphotrapeziotrapezoid joint without image guidance in a cadaveric model [23]. Thumb movements do not induce large STT rotations, suggesting that the thumb does not need to be immobilized in case of isolated STT osteoarthritis [19].

Investigations

Plain radiography: Radiographic evaluation of STT osteoarthritis is limited by uncertainty in assessment and the high prevalence of concomitant trapeziometacarpal and STT osteoarthritis [6]. This diagnostic ambiguity necessitates intraoperative visualization of the STT joint to determine the true degree of degenerative changes [6]. A simple, reproducible technique for assessing the scaphotrapezotrapezoid joint radiographically involves pronation, ulnar deviation, and thumb abduction [40]. The sensitivity of the radiographic diagnosis for scaphotrapezoid arthritis was 44% and the specificity was 86% [50].

Other Considerations: The true prevalence of scaphotrapezoid arthritis was 62% in thumbs undergoing trapezium excision arthroplasty [50]. Midcarpal arthrography confirms the diagnosis of STT ligament injury, with leakage of contrast medium observed over the external part of the STT space [7].

Treatment

Non-Operative

The provided evidence does not detail specific conservative management protocols such as weight loss, physical therapy, or pharmacological interventions. Surgical options for STT arthritis depend on the specific clinical scenario [4].

Operative

Indications: Prospective randomized control trials are required to determine the optimal treatment for STT osteoarthritis [11]. The literature reflects a lack of consensus regarding the most effective treatment, with most available data consisting of retrospective case series of particular techniques with short to medium-term follow-up [25]. In all cases of isolated or associated STT OA, maintaining scaphoid height is a crucial element of surgical treatment [10]. Additionally, performing oblique trapezoidal osteotomy to prevent scaphoid–metacarpal impingement is a crucial element of surgical treatment in all cases of isolated or associated STT OA [10]. STT subluxations require surgical treatment [7].

Surgical Approach / Technique: The traditional surgical treatment of STT OA is arthrodesis, which has been reported as having a high complication rate by a number of authors [25]. Achieving union in STT arthrodesis can be a challenge requiring strict adherence to surgical and postsurgical guidelines [8]. Isolated cases of STT arthritis are often managed by distal scaphoid resection or arthrodesis [4]. Open excision of the distal pole of the scaphoid is offered for patients with isolated STT arthritis and no carpal malalignment because it is less technically demanding with fewer reported complications [9]. Excisional arthroplasty is highly recommended for idiopathic, symptomatic, isolated STT osteoarthritis without midcarpal instability [22]. This procedure provides reliable results, is less technically demanding, requires less prolonged immobilization, and has fewer complications than localized arthrodesis [22]. Cases of STT arthritis with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision [4]. Modified total trapezial, partial trapezoidal excision and ligament reconstruction tendon interposition (LRTI) could be an effective surgical alternative in cases of isolated STT arthritis [14].

Implant Selection: The Scaphoid Trapezium Pyrocarbon Implant (STPI) may prove a useful compromise treatment for isolated scaphotrapeziotrapezoid joint arthritis, as suggested by pilot study results [33]. The Pyrocardan resurfacing implant is a valid option for treating STT osteoarthritis, supported by good functional and radiographic outcomes and the absence of surgical complications [37]. The application of a pyrocarbon implant in the treatment of STT arthrosis is confirmed by good results, a simple surgical procedure, and the absence of complications, which does not require any fixation nor ligamentoplasty [56]. Double STT and TM pyrocarbon interposition implants offer good results at midterm for patients suffering from pantrapezial OA [60]. The Pyrocardan implant may be contraindicated in patients with symptomatic STT OA who intend to continue high-load activities, particularly those involving wrist extension under load, such as tennis [80].

Other Considerations: Long-term results of STT arthrodesis for arthritis have been encouraging, achieving a good range of motion together with good strength and function [8]. STT arthrodesis with staple fixation to treat isolated STT OA led to a significant reduction in pain, with improved strength and functional scores [12]. At a mean follow-up of 10 years, patients undergoing STT arthrodesis have a 10% risk of reoperation [18]. The risk of reoperation after STT arthrodesis decreases with older patient age [18]. STT arthrodesis with vascularized bone grafting from the radius was effective in STT arthrodesis, but more clinical cases with long-term follow-up are required to establish its effectiveness and complications [36]. The grip and pinch strength after STT arthrodesis combined with “De La Caffinière” arthroplasty for pan-trapezial osteoarthritis were comparable to the results of the literature [42]. The midterm results for distal pole resection of the scaphoid in the treatment of STT-OA and scaphoid nonunion are satisfactory [57]. Moderate degenerative changes at the ST joint do not necessitate complete trapezial resection when coexisting with trapeziometacarpal disease [16]. Partial trapeziectomy for TM joint arthritis provides long-lasting relief of symptoms in patients with radiographically abnormal but clinically insignificant ST joint degeneration [17]. The combination of STT osteoarthritis and static dorsal intercalated segment instability (DISI) was found in 16 wrists, which was statistically significant (0.02 < P < 0.05) [24]. Surgically treated cases of STT subluxation have a favourable course, at least in the short term [7].

Complications

Arthrodesis

STT arthrodesis carries a high complication rate [25]. Patients undergoing this procedure face a 10% risk of reoperation at a mean follow-up of 10 years [18]. Further clinical cases with long-term follow-up are required to establish the complications associated with STT arthrodesis using vascularized bone grafting [36].

Excision Arthroplasty

Excisional arthroplasty presents fewer complications than localized arthrodesis [22]. However, excision arthroplasty for STT arthritis can provoke severe malalignment and midcarpal instability [38]. This midcarpal instability may lead to an intercarpal arthrodesis, resulting in an outcome potentially worse than STT fusion [38]. Flexor tendon rupture is a specific complication of distal scaphoid excision for STT arthritis [55]. This rupture is caused by a sharp remaining edge of the proximal scaphoid [55].

General Surgical Considerations

Maintaining scaphoid height and performing oblique trapezoidal osteotomy are crucial elements of surgical treatment to prevent complications such as scaphoid–metacarpal impingement [10].

Recovery

Postoperative Outcomes and Complications: STT arthrodesis for isolated idiopathic STT arthritis yields very satisfactory results with minimal complications [3]. Long-term results of STT arthrodesis for arthritis are encouraging, achieving good range of motion, strength, and function [8]. Specifically, STT arthrodesis with staple fixation for isolated STT OA leads to a significant reduction in pain, with improved strength and functional scores at a mean 8 years’ follow-up [12]. In a cohort of 18 patients treated with double STT and TM pyrocarbon interposition implants for pantrapezial OA, two patients required revision surgery [60]. STT arthrodesis with vascularized bone grafting from the radius is effective, but more clinical cases with long-term follow-up are required to establish effectiveness and complications [36].

Alternative Procedures: Excisional arthroplasty for idiopathic, symptomatic, isolated STT osteoarthritis without midcarpal instability provides reliable results, requires less prolonged immobilization, and has fewer complications than localized arthrodesis [22]. Midterm results for distal pole resection of the scaphoid in the treatment of STT-OA and scaphoid nonunion are satisfactory [57]. Modified total trapezial, partial trapezoidal excision and ligament reconstruction tendon interposition (LRTI) is an effective surgical alternative for isolated STT arthritis [14]. The Pyrocardan resurfacing implant for STT osteoarthritis demonstrates good functional and radiographic outcomes with an absence of surgical complications at a minimum follow-up of 2 years [37]. Double STT and TM pyrocarbon interposition implants for pantrapezial OA show significant reduced pain and improvement in QuickDASH, PRWE scores, and pinch strength at a mean follow-up of 44 months [60]. Good or excellent subjective results were achieved in 9 patients at a final review at an average of 36 months after arthroscopic debridement for isolated STT arthritis [99]. Results of triscaphe arthrodesis at an average of 5 years after operation are similar to earlier reports of the procedure [98].

Diagnostic and Preoperative Considerations: The prevalence of concomitant trapeziometacarpal and STT OA, and the uncertainty of radiographic evaluation of STT OA, indicate the need to visualize the STT joint intraoperatively to determine the true degree of degenerative changes [6]. Non-operative treatment of STT subluxation resulted in functional disability and X-ray changes in one reported patient, whereas surgically treated cases have a favorable course at least in the short term [7].

Key Evidence

  • [L3] STT joint OA is a common finding on hand radiographs of patients presenting to a hand clinic. [1] (10.1016/j.jhsa.2014.05.033)
  • [L4] It is concluded that for isolated idiopathic STT arthritis, fusion gives very satisfactory results with minimal complications. [3] (10.1016/s0266-7681(05)80208-6)
  • [L5] Surgical options for STT arthritis depend on the specific clinical scenario, with isolated cases often managed by distal scaphoid resection or arthrodesis, while cases with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision. [4] (10.5435/jaaos-d-19-00539)
  • [L4] Patients with STT arthritis may present with carpal instability not related to radiographic scapholunate instability, characterized by a normal scapholunate angle with scaphoid extension. [5] (10.1016/j.jhsa.2006.10.021)
  • [Paper] The prevalence of concomitant trapeziometacarpal and STT OA, and the uncertainty of radiographic evaluation of STT OA, indicate the need to visualize the STT joint intraoperatively to determine the true degree of degenerative changes present. [6] (10.1016/s0363-5023(03)00258-2)
  • [L5] [7] (10.1016/s0266-7681(97)80059-9)
  • [L4] The authors' long-term results of STT arthrodesis for arthritis have been encouraging, achieving a good range of motion together with good strength and function, though achieving union can be a challenge requiring strict adherence to surgical and postsurgical guidelines. [8] (10.1016/j.hcl.2005.08.001)
  • [L4] There is insufficient evidence to definitively support one approach over the other, but the authors offer open excision of the distal pole of the scaphoid for patients with isolated STT arthritis and no carpal malalignment due to it being less technically demanding with fewer reported complications. [9] (10.1016/j.jhsa.2012.05.007)
  • [Paper] In all cases (isolated or associated STT OA) and no matter the technique chosen, maintaining the scaphoid height (arthrodesis, resection < 3 mm and/or associated interposition) and performing oblique trapezoidal osteotomy (to prevent scaphoid–metacarpal impingement) are the two crucial elements of surgical treatment. [10] (10.1016/j.hansur.2020.12.007)
  • [L5] Prospective randomized control trials are required in future to decide the optimal treatment for STT OA. [11] (10.1055/s-0040-1708523)
  • [L4] STT arthrodesis with staple fixation to treat isolated STT OA led to a significant reduction in pain, with improved strength and functional scores. [12] (10.1016/j.hansur.2021.04.014)
  • [L5] [13] (10.1016/s0363-5023(03)00302-2)
  • [L4] Modified total trapezial, partial trapezoidal excision and LRTI could be an effective surgical alternative in cases of isolated STT arthritis. [14] (10.1177/1753193411434718)
  • [L4] Arthroscopic STT arthroplasty provides satisfactory relief of pain and return of strength and function. [15] (10.1016/s0363-5023(09)60127-1)
  • [L4] The authors conclude that moderate degenerative changes at the ST joint do not necessitate complete trapezial resection. [16] (10.1016/0363-5023(92)90303-7)
  • [L4] Partial trapeziectomy for TM joint arthritis provides long-lasting relief of symptoms in patients with radiographically abnormal but clinically insignificant ST joint degeneration. [17] (10.1016/j.jhsa.2012.02.007)
  • [L3] At a mean follow-up of 10 years, patients undergoing STT arthrodesis have a 10% risk of reoperation, and this risk decreases with older patient age. [18] (10.1177/1558944720964972)
  • [L4] The finding that thumb movements do not induce large STT rotations suggests that the thumb does not need to be immobilized in case of isolated STT osteoarthritis. [19] (10.1002/jor.24700)
  • [L3] We report a 31% incidence of end-stage ST joint arthritis in surgically treated patients with CMC arthritis based on visual inspection, which is lower than previous literature. [21] (10.1177/1558944718765246)
  • [L4] Excisional arthroplasty is highly recommended for idiopathic, symptomatic, isolated STT osteoarthritis without midcarpal instability, as it provides reliable results, is less technically demanding, requires less prolonged immobilization, and has fewer complications than localized arthrodesis. [22] (10.1016/j.jhsa.2010.12.016)
  • [L4] A dorsal approach was found to be the safest and most reproducible technique in a cadaveric model. [23] (10.1016/j.jhsg.2021.05.003)
  • [L4] The combination of STT osteoarthritis and static DISI was found in 16 wrists, which was statistically significant (0.02 < P < 0.05). [24] (10.1016/0266-7681(94)90084-1)
  • [L1] [25] (10.1142/s0218810417300017)
  • [L4] DISI was identified in 3 grade 2 wrists (5%), and 44 grade 3 wrists (60%). [26] (10.1016/j.jhsa.2025.11.018)
  • [L5] It isolates the articular surfaces of the trapezoid and shows the whole joint, including good visualization of the trapeziotrapezoid and STT joints with the second metacarpal, free of most overlap. [28] (10.1016/j.jhsa.2005.05.009)
  • [L4] Surgical treatment of isolated STT osteoarthritis resistant to conservative treatment leads to significant functional improvement, particularly in terms of pain, without altering the wrist’s overall mobility. [29] (10.1016/j.hansur.2019.11.005)
  • [L5] Surgical options for scaphotrapeziotrapezoidal joint osteoarthritis are numerous, but none has clear evidence of superiority. [30] (10.1177/17531934241295345)
  • [L4] The results of this pilot study suggest that the STPI may prove a useful compromise treatment for isolated scaphotrapeziotrapezoid joint arthritis. [33] (10.1016/j.jhsb.2006.05.006)
  • [L4] Acceptable results can be obtained by an arthroscopic distal scaphoid resection for STT osteoarthritis. [35] (10.1016/j.jhsa.2016.07.019)
  • [L4] The procedure was effective in STT arthrodesis, but more clinical cases with long-term follow-up are required to establish the effectiveness and complications of STT arthrodesis with VBG. [36] (10.1177/1753193411419629)
  • [L3] The good functional and radiographic outcomes, and the absence of surgical complications are evidence that the Pyrocardan1 resurfacing implant is a valid option for treating STT osteoarthritis. [37] (10.1016/j.hansur.2017.01.003)
  • [L4] The procedure can provoke severe malalignment and midcarpal instability, leading to an intercarpal arthrodesis with an outcome potentially worse than STT fusion. [38] (10.1177/1753193408098903)
  • [L4] [39] (10.1016/j.hcl.2008.03.002)
  • [L5] A simple, reproducible technique for assessing the scaphotrapeziotrapezoid joint radiographically is described. [40] (10.1097/bth.0000000000000199)
  • [L4] We achieved good results with a relatively easy technique requiring a shorter postoperative immobilisation period than STT arthrodesis. [41] (10.1016/j.hansur.2020.03.005)
  • [L4] The grip and pinch strength were comparable to the results of the literature. [42] (10.1016/0266-7681(93)90165-c)
  • [L4] The presence of 2 locations of arthritis may explain persistent hand and wrist pain in this population despite CMC arthroplasty. [44] (10.1177/1558944716660555hw)
  • [L4] The true prevalence of scaphotrapezoid arthritis was 62%, while the sensitivity of the radiographic diagnosis was 44% and the specificity was 86%. [50] (10.1053/jhsu.1999.1220)
  • [L4] SPECT/CT is able to differentiate between osteoarthritic pain arising from the trapeziometacarpal joint and the scaphotrapeziotrapezoid joint. [53] (10.1177/1753193415606070)
  • [L4] Flexor tendon rupture is a previously unreported complication of distal scaphoid excision for STT arthritis, caused by a sharp remaining edge of the proximal scaphoid. [55] (10.1177/1558944717708028)
  • [L4] The good results, the simple surgical procedure and the absence of complication confirm the application of this pyrocarbon implant in the treatment of STT arthrosis, which furthermore does not require any fixation nor ligamentoplasty. [56] (10.1016/s0363-5023(03)80381-7)
  • [L4] The midterm results for distal pole resection of the scaphoid in the treatment of STT-OA and scaphoid nonunion are satisfactory. [57] (10.1177/1558944716660555ix)
  • [L4] [59] (10.5435/jaaos-d-25-01408)
  • [L4] [60] (10.1016/j.otsr.2021.102979)
  • [Case_report] The Pyrocardan implant may be contraindicated in patients with symptomatic STT OA who intend to continue high-load activities, particularly those involving wrist extension under load, such as tennis. [80] (10.1016/j.jhsg.2026.100964)
  • [L5] The scaphoid/trapezoid motion was found to be a rotational motion obliquely oriented relative to the sagittal plane of the wrist and described in an ulnoflexion radial extension motion plane in both FEM and RUD of the wrist. [83] (10.1053/jhsu.2000.8637)
  • [L3] [87] (10.1016/j.jhsa.2015.12.028)
  • [Paper] [96] (10.1016/j.hcl.2011.05.001)
  • [L4] These results at an average of 5 years after operation are similar to our earlier reports of triscaphe arthrodesis. [98] (10.1016/0363-5023(90)90100-6)
  • [L4] Good or excellent subjective results were achieved in 9 patients at final review at an average of 36 months after arthroscopic debridement. [99] (10.1016/s0363-5023(03)00368-x)

See Also

References

[1] Radiographic Prevalence of Scaphotrapeziotrapezoid Osteoarthrosis. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.05.033

[3] Results of Scaphotrapeziotrapezoid Fusion for Isolated Idiopathic Arthritis. Journal of Hand Surgery. 1996. DOI: 10.1016/s0266-7681(05)80208-6

[4] Surgical Management of Scaphotrapeziotrapezoid Arthritis. Journal of the American Academy of Orthopaedic Surgeons. 2020. DOI: 10.5435/jaaos-d-19-00539

[5] The Clinical Implications of Scaphotrapezium-Trapezoidal Arthritis With Associated Carpal Instability. The Journal of Hand Surgery. 2007. DOI: 10.1016/j.jhsa.2006.10.021

[6] Radiography and visual pathology of the osteoarthritic scaphotrapezio-trapezoidal joint, and its relationship to trapeziometacarpal osteoarthritis. The Journal of Hand Surgery. 2003. DOI: 10.1016/s0363-5023(03)00258-2

[7] Scaphotrapeziotrapezoid Osteoarthritis after Scaphotrapezial Ligament Injury. Journal of Hand Surgery. 1997. DOI: 10.1016/s0266-7681(97)80059-9

[8] Scaphotrapeziotrapezoid Arthrodesis for Arthritis. Hand Clinics. 2005. DOI: 10.1016/j.hcl.2005.08.001

[9] Scaphotrapezium-Trapezoid Arthrosis. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.05.007

[10] Scaphotrapeziotrapezoid osteoarthritis: From the joint to the patient. Hand Surgery and Rehabilitation. 2021. DOI: 10.1016/j.hansur.2020.12.007

[11] Scaphotrapeziotrapezoid Osteoarthrosis. Journal of Wrist Surgery. 2020. DOI: 10.1055/s-0040-1708523

[12] Scaphotrapeziotrapezoid arthrodesis for isolated osteoarthritis: results at a mean 8 years’ follow-up. Hand Surgery and Rehabilitation. 2021. DOI: 10.1016/j.hansur.2021.04.014

[13] Nontraumatic multidirectional instability of the scaphotrapeziotrapezoid joint: a cause of scaphotrapeziotrapezoid osteoarthritis and static distal intercalated segment instability. The Journal of Hand Surgery. 2003. DOI: 10.1016/s0363-5023(03)00302-2

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[22] Excisional Arthroplasty for Scaphotrapeziotrapezoidal Osteoarthritis. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.12.016

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