Description and Outcomes of a New Technique for Thumb Basal Joint Arthroplasty

Sammer, Douglas M.; Amadio, Peter C.

doi:10.1016/j.jhsa.2010.04.030

Cited by 24 publications

(6 citation statements)

References 19 publications

(15 reference statements)

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“…13,[29][30][31] Some methods use the APL for suspension. 15,32 In lieu of tendon harvesting, some methods use a suture suspension construct for stabilization. An index suture anchor with fascia lata interposition has been described.…”

Section: Discussionmentioning

confidence: 99%

Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up

DelSignore

Zambito²,

Ballatori

2021

Hand (New York, N,Y.)

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Background Many surgical procedures have been described for the treatment of thumb carpometacarpal (CMC) joint osteoarthritis, with significant variation. To date, none has proven to be superior. The purpose of this study was to report long-term follow-up results of suture suspension arthroplasty (SSA). Methods The SSA technique uses a single incision, trapeziectomy, and an intra-articular suture suspension sling anchored into the insertions of the flexor carpi radialis (FCR) and abductor pollicis longus (APL), which serves to stabilize the base of the thumb metacarpal, correct subluxation deformity, and maintain arthroplasty space. Ninety of 153 SSA reconstructions (59% recall) were evaluated at long-term follow-up (mean, 12.6 years). Data were analyzed for functional outcomes, including preoperative and postoperative grip and pinch strength, radiographs, complications, and postoperative Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores. Results The mean age at date of surgery was 61.7 ± 7.6 years (82% women). Significant improvement was noted in grip strength (preoperative mean, 25.0 kg; postoperative mean, 28.0 kg; P < .0001), key pinch (preoperative, 4.2 kg; postoperative, 5.1 kg; P < .0001), and tip pinch (preoperative, 2.9 kg; postoperative, 3.6 kg; P < .0001). Radiographic subsidence averaged 35% (0-90). Postoperative QuickDASH scores (mean, 6.6; range, 0-50) revealed good to excellent pain relief and function. One revision was performed, and postoperative FCR rupture occurred in 3 reconstructions. Conclusions The SSA technique for thumb CMC arthritis reconstruction yields good to excellent long-term clinical outcomes. Potential advantages of the SSA include short operative time, a single incision, minimal cost, and no need for tendon harvesting, pin fixation, or implantable hardware.

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Section: Discussionmentioning

confidence: 99%

Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up

DelSignore

Zambito²,

Ballatori

2021

Hand (New York, N,Y.)

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“…Although the results of pain relief and improvement in hand function are satisfactory, subsidence of first metacarpal and impingement to scaphoid led the surgeons to popularize new methods aiming to maintain trapezial space height and stabilize the first metacarpal. Hematoma distraction technique using Kirschner wire is the simplest and ligament reconstruction and tendon interposition (LRTI) is the most popular techniques to prevent subsidence and maintain first ray height after trapeziectomy 18 , 19 , 20 , 21 . Another alternative technique used for same purpose and popular in recent years is SB suspensionplasty.…”

Section: Discussionmentioning

confidence: 99%

Technical trick in suture-button suspensionplasty for the treatment of thumb carpometacarpal arthritis

Cavit¹,

Ci̇van

Özcanlı

2021

Handchir Mikrochir Plast Chir

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Suture-button suspensionplasty has been popularized in the treatment of thumb carpometacarpal (CMC) arthritis in recent years. The surgical technique of this method was well defined previously. The most challenging and important part of this technique is the tensioning of the suture-button system to preserve first metacarpal height after trapeziectomy. In present study, we would like to present a technical trick about adjusting the tension while performing suspensionplasty using suture-button device in thumb CMC joint osteoarthritis. In the original technique, trapeziectomy is performed prior to fixation and tensioning of suture-button system. However, it is quite difficult to recreate the original trapezial space, since first metacarpal subsides after trapeziectomy. The trick in our technique is that trapezium remains in its anatomic position up to the end of the operation. Thus, we do not need to make effort to adjust the thumb ray height and use fluoroscopic imaging to ensure its position. In conclusion, we believe that our technique simplifies the most challenging part of the operation, shortens the operation time, preserves the original first ray height and diminishes the exposure of ionizing radiation as it reduces the need for fluoroscopy.

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“…The surgical approach and techniques used by the attending surgeons are similar to previously described techniques in the literature, including the suspension sling arthroplasty, the abductor pollicis longus suspensionplasty, and the ligament reconstruction tendon interposition. 6 , 7 , 8 , 9 , 10 , 11 , 12 After surgery, postoperative immobilization and rehabilitation programs were individualized based on the discretion of the attending physicians. Activity restrictions continued for up to 10–12 weeks after surgery.…”

Section: Methodsmentioning

confidence: 99%

“… 5 Arthroplasty of the basal joint of the thumb has been shown by multiple authors to reliably decrease pain, improve strength, and improve range of motion. 6 , 7 , 8 , 9 , 10 , 11 , 12 It has allowed patients to return to activities of daily living and work, but does it also allow patients to return to sports and recreational activities?…”

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confidence: 99%

Return to Sports and Recreational Activities Following Arthroplasty of the Basal Joint of the Thumb: A Retrospective Review

Labriola,

Smith,

Merrell

2024

Journal of Hand Surgery Global Online

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Description and Outcomes of a New Technique for Thumb Basal Joint Arthroplasty

Cited by 24 publications

References 19 publications

Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up

Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up

Technical trick in suture-button suspensionplasty for the treatment of thumb carpometacarpal arthritis

Return to Sports and Recreational Activities Following Arthroplasty of the Basal Joint of the Thumb: A Retrospective Review

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Description and Outcomes of a New Technique for Thumb Basal Joint Arthroplasty

Cited by 24 publications

References 19 publications

Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up

Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up

﻿Technical trick in suture-button suspensionplasty for the treatment of thumb carpometacarpal arthritis

Return to Sports and Recreational Activities Following Arthroplasty of the Basal Joint of the Thumb: A Retrospective Review

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Technical trick in suture-button suspensionplasty for the treatment of thumb carpometacarpal arthritis