Ligament reconstruction arthroplasty for trapeziometacarpal arthrosis

Twenty-eight patients (30 thumbs) were evaluated after ligament reconstruction arthroplasty for trapeziometacarpal arthrosis. The mean patient age was 60 years, 86% were women, and the average follow-up period was 38 months. Subjective results showed excellent (40%) or good (57%) pain relief in 97% of patients. Return to previous work or activity level was achieved in 98%. Eighty-six percent of patients expressed overall satisfaction with the surgical outcome, mostly because of pain relief. Functional improvement was reported for many activities, except jar opening, which continued to be the most difficult task to perform. Thumb mobility improved, while key pinch strength showed an overall decrease of 27%. Proximal migration of the thumb metacarpal measured 27%, and radial subluxation was negligible. Thumb metacarpophalangeal joint hyperextension was present to some degree in more than 50% of patients before surgery and in 7 of 30 thumbs (23%) after surgery. Hyperextension was prevalent among women on hormone-replacement therapy, including 3 patients in whom these deformities recurred in spite of attempts to stabilize their joints during surgery.