Functional evaluation of tendon interposition arthroplasty of the trapeziometacarpal joint

The carpometacarpal joint of the thumb is a frequent site of pain and disability secondary to arthritis. Surgical treatment for this disease has included arthrodesis, excision, total joint replacement, ligament reconstruction, and tendon or synthetic interposition arthroplasty. The aim of treatment is a functional, pain-free thumb. This study includes 11 patients operated upon utilizing tendon interposition arthroplasty; three patients had bilateral surgery. The primary disease was osteoarthritis in nine patients and rheumatoid arthritis in two. Average followup length postoperatively was 53 months. All patients experienced increased function and alleviation of pain after surgery. Average key pinch measured 8.4 pounds in the osteoarthritic female group. Palmar and radial abduction as well as opposition were full postoperatively. This study shows that tendon arthroplasty provides a painless, well-functioning thumb. Its main advantages over other procedures are the acceptable range of motion obtained, a short postoperative immobilization period, and the ease of its surgical technique. Indexing terms: tendon arthroplasty; osteoarthritis; rheumatoid arthritis; trapeziometacarpal joint.