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Prospective Cohort Study Comparing Ligament Reconstruction with Tendon Interposition and Suture-Only Suspension
Thomas M Suszynski1, John R Fowler2, Maria Munsch2
1From the Departments of Surgery (Plastic Surgery) and Orthopedic Surgery, University of Minnesota Medical Center.
Plastic and Reconstructive Surgery
|March 13, 2023
Summary
Basal joint arthritis treatment using ligament reconstruction with tendon interposition (LRTI) or suture-only suspension arthroplasty (SSA) after trapeziectomy showed similar outcomes in pain, function, and strength recovery over six months.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Osteoarthritis treatment
Background:
- Basal joint arthritis, a common osteoarthritis form, lacks a consensus procedure for trapezial height maintenance post-trapeziectomy.
- Suture-only suspension arthroplasty (SSA) offers a straightforward method for stabilizing the thumb metacarpal after trapeziectomy.
Purpose of the Study:
- To compare the efficacy of trapeziectomy followed by ligament reconstruction with tendon interposition (LRTI) versus suture-only suspension arthroplasty (SSA) for treating basal joint arthritis.
Main Methods:
- A prospective, single-institution cohort study compared LRTI and SSA procedures performed between May 2018 and December 2019.
- Outcomes including pain scores, functional scores (Disabilities of the Arm, Shoulder and Hand), range of motion, strength, and patient-reported outcomes were assessed preoperatively and at 6 weeks and 6 months postoperatively.
Main Results:
- Both LRTI and SSA groups showed significant improvements in pain and function (P < 0.0001) over six months, with no significant differences between the groups.
- Thumb opposition improved post-SSA (P = 0.02) but not significantly post-LRTI (P = 0.16).
- Grip and pinch strength decreased initially but recovered similarly in both groups by six months. Patient-reported outcomes were comparable.
Conclusions:
- Ligament reconstruction with tendon interposition (LRTI) and suture-only suspension arthroplasty (SSA) are comparable procedures for post-trapeziectomy basal joint arthritis regarding pain, function, and strength recovery.
