Trapeziectomy and tendon suspension with or without a Mitek anchor fixation in the thumb basal joint osteoarthritis

Abstract

Partial trapeziectomy with suspension ligamentoplasty is a commonly performed treatment of thumb osteoarthritis. Nevertheless, the post-operative recovery remains long and critical reason for which different modifications of the surgical technique have been proposed. To compare two suspension ligamentoplasty techniques, one with a mitek anchor and another without, a retrospective study of 55 consecutive operated patients was performed. A detailed clinical analysis of pain, function and a radiologic assessment of the trapeziometacarpal space were performed. Mitek anchor fixation was associated with a shorter convalescence period. However, in spite of an improved radiological maintenance of the scaphometacarpal space, mitek anchor fixation was associated with an impaired postoperative function and residual pain when compared with the conventional suspension ligamentoplasty procedure. Patient's satisfaction was comparable in both groups. In our series stabilization of the suspension ligamentoplasty procedure by the insertion of a mitek anchor did not bring the hoped benefits to the patients with a trapeziometacarpal arthritis.

First Carpometacarpal Arthroplasty with Ligamentous Reconstruction: A Long-Term Follow-up

“…A study by Brand [13] included patients 1-7 years following a CMC suspension arthroplasty and found that the vast majority of patients (40 of 41) were subjectively satisfied but included no objective measures other than scaphometacarpal joint space distance. A number of other short-term outcome studies following CMC suspension arthroplasty with the use of FCR [14,15] or APL [16,17] also obtained results Table 2). Our study reinforces the longevity of these outcomes up to 15 years postoperative.…”

Interposition Arthroplasty Versus Hematoma and Distraction for the Treatment of Osteoarthritis of the Trapeziometacarpal Joint

“…The resection-suspension arthroplasty and its variants gave generally good results, [18][19][20] although with a significant incidence of specific complications, such as instability at the site of resection, complex regional pain syndrome (CRPS) and, in the Authors' experience, flexor carpi radialis tendinitis.…”

High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis

“…Our 25% incidence of FCR tendinitis is higher than other articles describing similar suspensionplasty (Belcher and Nicholl, 2000; Sigfusson and Lundborg, 1991; Sirotakova et al, 2007). Some have not even described any post-operative tendinitis (Chang and Chung, 2008; Nordback et al, 2012; Rutegård et al, 1994; Saehle et al, 2002; Tomaino, 2006). We postulate that our use of a removable post-operative splint could perhaps lead to poor compliance in using the splint during the first 6 weeks of immobilization.…”