With the presented procedure it is possible to achieve in the majority of the treated patients good and very good results. 2 early removals of the implants, a documented proximalisation in spite of the implant and the price of the Mini TightRope(®) of currently 225 Euro need to be discussed critically.

The aim of the current study was to review the significance of the TightRope ® to suspend the first metacarpal in the case of a revision for patients with painful proximalisation after trapezectomy. Patients and Method:After an average of 25.5 months (13-60) from initial operative treatment for rhizarthrosis, revision surgery was performed on 6 female patients with a mean age of 56 years, using a Mini TightRope ® . Before and after revisionsurgery the pain level was measured, using the visual analogue scale (1-10) as was the level of strength in the fingertips. The overall result was documented according to the evaluation scale according to BuckGramcko. Directly after surgery as well as at the last followup exam, the degree of proximalisation of the first metacarpal was radiologically measured. The followup period was 13.7 months on average (4-31 months). Results: After revision surgery a decrease in pain level was detected, but no patient was completely painfree. According to the visual analogue scale the pain level after surgery compared to preoperatively was: at rest at an average of 2.5 (1-4), preoperatively 3.3 (2-4); with mild load 3.5 (2-5), preoperatively 4.8 (4-6); and with high load 4.8 (3-7), preoperatively 7 (6-8). The level of strength in the fingertips was postoperatively measured at below 60 % in 2 patients (preoperatively 5 patients), once between 60 and 79 % (preoperatively 1 patient) and 3 times between 80 and 99 %. With an average preoperative score of 11.7 (6-16) points according to BuckGramcko, an increase of 20.3 points could be achieved by performing the revision operation. This resulted in a score of 32 (14-44) out of 56 points. The measured distance between the distal scaphoid pole and the centre of the base of the first metacarpal was postoperatively at an average of 8.3 mm (5.6-11.4 mm).