Long-term results of tendon shortening trapeziometacarpal arthroplasty

Multiple soft tissue arthroplasties have been described for reconstruction of trapeziometacarpal arthritis. Trapeziectomy with abductor pollicis longus tendon shortening has been reported to have favorable short-term results, with 95% to 100% good or excellent pain relief at an average of 18 to 31 months. No long-term results of this reconstruction have been published. In the current study, 29 abductor pollicis longus shortening arthroplasties were reviewed at an average of 5.1 years. Although 83% of patients experienced good or excellent pain relief, pinch weakness, a small arthroplasty space, and first metacarpal instability were present in numerous patients. Because of these problems observed at long-term followup, the authors now use ligament reconstruction tendon interposition as the primary trapeziometacarpal arthroplasty.