Patient Outcomes of Thumb Arthroplasty Using a Hybrid Technique for Severe Osteoarthritis

Patient-based evaluations effectively quantify a patient's perception of the impact of a disorder and surgical results. With multiple surgical techniques for thumb carpometacarpal (CMC) arthritis, we propose a hybrid technique combining trapeziectomy with ligament reconstruction and tendon interposition and suture button suspensionplasty to evaluate its statistical significance and clinical relevance.

We conducted a retrospective study on patients receiving primary surgery of combining trapeziectomy with ligament reconstruction and tendon interposition and suture button suspensionoplasty for advanced osteoarthritis from 2017 to 2023. Patient-reported outcome measurements (PROMs) including Quick Disabilities of the Arm, Shoulder and Hand, pain visual analog scale (VAS), and single assessment numeric evaluation (SANE) were analyzed at 2 years. Receiver operating characteristic curves derived clinically significant outcome (CSO) thresholds of minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS).

PROMs from 32 hands (31 patients) exhibited significant difference at 2 years postoperatively. CSO thresholds of MCID were 18.2, 1, and 70 for Quick Disabilities of the Arm, Shoulder and Hand, VAS, and SANE, respectively. SCB values were 15.9, 1, and 75, and PASS were 18.2, 0, and 80. More than 80% of patients achieved CSO thresholds in all 3 scores, except for PASS in VAS and SANE scores, with 70% and 72% of patients reaching these cutoff values.

Significant improved difference were observed in 2-year PROMs, with most patients achieving MCID and SCB but not PASS for VAS and SANE scores. Continued observation of patients' perspectives on this surgery is warranted.