Novel Use of Meniscal Allograft Arthroplasty for Basal Joint Arthritis in a Patient With Ehlers-Danlos Syndrome - A Case Report

Sep 29, 2026

Ehlers-Danlos Syndrome (EDS) presents surgical challenges due to connective-tissue fragility and impaired collagen synthesis. Thumb carpometacarpal (CMC) arthritis is common and often requires operative management for pain relief and functional improvement. A 56-year-old woman with EDS selected surgical treatment after persistent joint pain despite one year of conservative care. With no complications, postoperative recovery was unremarkable, pain reporting decreased substantially, and daily activities returned to baseline without restrictions at six months.

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CategoryHealthcare

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Reading Time15 min

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Review began 10/03/2025 Review ended 11/30/2025 Published 12/05/2025 © Copyright 2025 Vieira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98522 Open Access Case Report Novel Use of Meniscal Allograft Arthroplasty for Basal Joint Arthritis in a Patient With EhlersDanlos Syndrome: A Case Report Lucas Vieira 1, Emma M. Eng 1, Ritesh Chandrasekaran 1, Ehsan Esmaeili 2, 3 1. College of Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA 2. Department of Orthopaedic Surgery, Hand and Ortho, Boca Raton, USA 3. Department of Orthopaedics, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA Corresponding author: Emma M. Eng, [emmaeng15@gmail.com](emmaeng15@gmail.com) Abstract Ehlers-Danlos Syndrome (EDS) is a complex condition to treat surgically due to the nature of the disease. Thumb carpometacarpal (CMC) arthritis is a particularly prevalent condition that often requires surgical intervention for symptomatic and motor relief. A 56-year-old female patient with EDS opted for surgical treatment after persistent pain of the joint refractory to conservative treatment after one year. With no complications and an unremarkable recovery period, the patient has returned to baseline function with no restrictions in activities of daily living, significantly reduced reported pain, and a high level of reported satisfaction with the results of this procedure at six-month postoperative follow-up. This case report aims to highlight the outcomes of a possible treatment option for CMC arthritis in patients with EDS using meniscalallograft arthroplasty. Categories: Pain Management, Rheumatology, Orthopedics Keywords: connective tissue disorder, ehlers danlos syndrome, meniscal allograft, meniscal allograft arthroplasty, orthopaedic hand surgery, thumb basal joint arthroplasties, thumb carpometacarpal arthritis, thumb carpometacarpal joint osteoarthritis Introduction Ehler-Danlos Syndrome (EDS) is a heterogeneous connective tissue disorder affecting collagen synthesis. The impaired collagen synthesis leads to skin hyperextensibility, tissue fragility, and joint hypermobility [1] . Multiple tissue types are impacted in this condition, including the skin, ligaments, tendons, and cartilage [2] . EDS can often be challenging to diagnose due to ambiguity in clinical presentation and lack of definitive diagnostic testing [1] . Due to joint defects, patients with EDS often develop basal joint arthritis, also known as carpometacarpal (CMC) arthritis. Therefore, it is critical that physicians understand the variation in presentation of the condition and recognize the risks of developing chronic joint issues [3] . Physicians will first attempt non-operative treatment for CMC arthritis prior to opting for surgical intervention. Conservative approaches consist of “R-I-C-E”(Rest, Ice, Compression, Elevation), antiinflammatory analgesics, physical therapy, and splints. The efficacy of non-operative treatment varies and is highly dependent on the location and the severity of a patient’s symptoms [1] . After failing non-operative treatment, patients in one study demonstrated decreased pain levels, increased range of motion (ROM), and improved grip strength in this patient population following CMC allograft arthroplasty and trapeziectomy [4] . Despite multiple surgical options, it remains paramount to understand the risks associated with EDS inan operative setting, including recurrent ligament instability, worsening postoperative pain levels, infection, and failed intervention [1,5] . Meniscal allograft arthroplasty as a means of treating CMC arthritis remains sparsely investigated, and the use of this procedure has not yet

FAQs

Why is Ehlers-Danlos syndrome challenging for surgical treatment?

EDS involves impaired collagen synthesis leading to skin hyperextensibility, tissue fragility, and joint hypermobility, which complicates surgical management.

What condition was treated in this case report?

The report describes treatment of thumb carpometacarpal (CMC) or basal joint arthritis using meniscal allograft arthroplasty in a patient with EDS.

What were the outcomes after surgery at six months?

The patient had no complications, an unremarkable recovery, returned to baseline function without daily-activity restrictions, and reported significantly reduced pain with high satisfaction at six-month follow-up.

Sep 29, 2026

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