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Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
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Botox and Thumb MCP Radial Collateral Ligament Reconstruction
Robert A Cates1, Jeffrey S Brault2, Sanjeev Kakar1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Journal of Wrist Surgery
|March 27, 2018
Summary
Botulinum toxin injections can help treat thumb radial collateral ligament insufficiency. This treatment, combined with surgery, led to a pain-free and stable thumb after one year.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Medicine
- Regenerative Medicine
Background:
- Chronic radial collateral ligament (RCL) insufficiency of the thumb presents treatment challenges.
- Surgical outcomes for RCL repair/reconstruction can be unpredictable.
- The adductor pollicis muscle exerts significant deforming forces, complicating RCL treatment.
Observation:
- A patient with chronic RCL insufficiency underwent autograft tendon reconstruction and cast immobilization.
- Postoperatively, an ultrasound-guided botulinum neurotoxin A injection was administered to the adductor pollicis muscle.
- The injection aimed to counteract the deforming forces of the adductor pollicis on the RCL reconstruction.
Findings:
- The patient experienced an excellent recovery following the combined treatment.
- One year postoperatively, the patient was pain-free.
- Physical examination revealed a stable radial collateral ligament.
Implications:
- Botulinum toxin injections may be a valuable adjunct in managing thumb RCL insufficiency.
- Neutralizing the deforming forces of the adductor pollicis muscle can potentially improve surgical outcomes.
- This approach offers a novel strategy to enhance the success of RCL repair and reconstruction.
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