Trapezium Bone Resection Arthroplasty and Suspension With Suture Button for the Treatment of Trapeziometacarpal Osteoarthritis: Long-Term Follow-Up in a Colombian Cohort

Abstract

Purpose: Osteoarthritis of the trapeziometacarpal (TMC) thumb joint is one of the most common and debilitating degenerative osteoarthritic conditions of the hand. Two available surgical options include arthrodesis versus arthroplasty; the latter uses complete or partial trapeziectomy. Suspension with a suture button avoids the use of tendon grafts and favors early rehabilitation. Our purpose was to evaluate the long-term results of suspension arthroplasty using the suture button technique in a Colombian cohort. Methods: This was a retrospective study of clinical results of a cohort of patients with osteoarthritis of the TMC joint of the thumb, who were treated with trapezium resection arthroplasty plus suspension with a suture button. We included 15 patients (16 thumbs). Functional recovery and pain level were assessed through the grip and pinch strength tests, range of motion, QuickeDisabilities of the Arm, Shoulder, and Hand (QuickDASH) and Kapandji scores, and visual analog scale score of pain. Trapezial space was measured on preoperative and postoperative x-rays. Results: Average age of patients was 62.4 years; there were 14 women. One patient had bilateral involvement. Preoperative QuickDASH score was 70.45 and EatoneLittler classification of the 16 cases was II in 1, III in 6, and IV in 9 thumbs. Average follow-up was 33.75 months (range, 24e48 months) and average QuickDASH score was 24.7. Grip and pinch strengths were 96.9% and 108.3%, respectively, of the nonsurgical side. Average palmar and radial abduction was 92.8% and 101.1%, respectively of the nonsurgical thumb. Average Kapandji score was 9.33. During the last follow-up, the visual analog scale score was 2 or lower in 83.3% of cases. There was one complication of regional pain syndrome. Conclusions: In our population, TMC arthroplasty with suture button provided good functional results for patients with osteoarthritis of the TMC thumb joint, primarily related to pain relief, satisfaction, and early reincorporation into daily activities. Type of study/level of evidence: Therapeutic IV.

Suture suspension sling arthroplasty in thumb carpometacarpal joint arthritis: A case series

“…There are also various suturing techniques for creating the sling. Some surgeons have created the sling using an endobutton [ 14 , 15 ]. In this case series, all three patients with minimal CMC arthritis type 2 were treated with suspension sling arthroplasty.…”

Basal thumb arthritis: Treatment strategies for managing pain

“…It is integral to fine motor activities such as pinch, key and chuck grips as well as having an important role in power grips. 2,3 CMCJ osteoarthritis is more common in post-menopausal women, who make up approximately 80% of the patient population. The dominant hand is involved in 60-65% of cases.…”

“…The goal of surgical intervention is to eliminate pain and restore hand function while maintaining stability and mobility. 2 There is strong consensus that the removal of the arthritic articular surfaces of the thumb CMCJ is associated with good clinical outcomes. 4 A range of surgical options are available to achieve this goal.…”

“…Implant-related procedures include all surgical options where implants (cobalt chrome, titanium, pyrocarbon, silicon) are used to replace or recreate the joint articulation similar to knee or hip joint replacements. 2,8 Trapeziectomy with or without ligament reconstruction and tendon interposition…”