Massimo Coraina, Filippo Zanottia, Mattia Giardinia, Luca Gasperottia, Erica Invernizzia, Valeria Biasib, Umberto Lavagnoloa*
Rhizoarthrosis is a disabling disease of the hand that causes pain, stiffness and weakness of the thumb, resulting in impaired function and strength of the hand. Non-surgical treatment mostly consists of activity modifications, NSAID intake, splinting and corticosteroid intrarticular injections. After the failure of conservative treatment, various surgical options exist.
The acellular matrix ChondroFiller Liquid® is a resorbable filler based on type I collagen and a neutralizing solution, used to form a protective layer around the cartilage defect while stimulating the growth of chondrocytes and the consequent induction of cartilage regeneration.
Our study was aimed at the infiltration of ChondroFiller Liquid® on 43 patients, divided in two cohorts according to the Eaton-Littler classification (group A stage 1-2; group B stage 3-4). The objectives of the study were: evaluation of any adverse events; assessment of the Numeric Rate Scale (NRS); possible improvement of the grip strength evaluated with Jamar test and pinch test; possible improvement of the Disability of the Arm, Shoulder and Hand questionnaire (DASH score); evaluation of any modification of the cartilage component analyzed by serial MRI studies. The patients were assessed on an outpatient basis and recruited according to the inclusion criteria with x-ray and, only for group A, also with MRI. All patients were clinically evaluated with the Jamar test, Pinch test, NRS and DASH score. Subsequently, a single infiltration of ChondroFiller Liquid® under fluoroscopic guidance was performed, followed by a clinical re-evaluation 30 days after infiltration with the administration of DASH score and NRS. At 6 months all the patients were re-evaluated with Jamar test, Pinch test, NRS, DASH score and only the patients of group A underwent further MRI. The results of the study show that there was an improvement in pain symptoms, associated with an increase in force in the pincer and grip movements evaluated with clinical tests. MRI imaging showed a change in the joint profile in patients subjected to infiltration, in some patients with reduction of bone oedema and periarticular effusion. With this case, we wanted to emphasize that despite the developing technology, physical examination and clinical history are still the basic and low-cost diagnostic methods.