Stenosing tenosynovitis of the first extensor compartment of the wrist is known as de Quervain’s disease [1]. It is characterized by tendinopathy of the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) in their fibro-osseous sheath just proximal to the radial styloid. This results in tendinopathy and reactive thickening of the pulley of the first extensor compartment [2]. Manual work, advanced age, postpartum status and female gender are predisposing factors. In persons over 40 years old, incidence is 1.37 per 1,000 person-years [3].

Total joint replacement is one of the surgical options for trapeziometacarpal (TMC) osteoarthritis. Postoperative development of de Quervain’s tendinitis is a common complication. It typically presents 3 to 6 months after surgery and occurs in 4.3–21% of patients [4], [5], [6], [7], [8], [9]. This incidence is much higher than in the normal population and the exact cause is still unknown. Van Hove et al. demonstrated that TMC range of motion during thumb movement increased after implantation of a ball-in-socket joint [10]. This can be explained by the fact that the complex biomechanics of the TMC joint are altered after prosthetic replacement. The normal joint has two axes of rotation [11], and ball-in-socket replacement simplifies this to a single center of rotation in the trapezium. The present study hypothesis was that excursion of EPB and APL tendons is greater after total joint replacement than in the normal joint. This increases friction under the extensor retinaculum and predisposes to de Quervain’s disease.

The goal of this study was to measure tendon excursion in the first extensor tendon compartment before and after total TMC joint replacement in a cadaver model.