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First carpometacarpal arthroplasty with ligamentous reconstruction: a long-term follow-up

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HAND

Abstract

Background

The purpose of the present study is to evaluate a single surgeon’s short, intermediate, and long-term clinical, functional, and radiographic outcomes with a trapeziectomy with flexor carpi radialis (FCR) suspension arthroplasty without tendon interposition (LRSA).

Methods

Twenty-one patients underwent 26 FCR suspension arthroplasties without tendon interposition by a single senior surgeon. All patients had Eaton stage III and IV carpometacarpal (CMC) osteoarthritis. The Patient-Rated Wrist and Hand Evaluation (PRWHE) and Quick Disabilities of Arm, Shoulder, and Hand (QuickDASH) were used to evaluate functional outcomes. A comprehensive strength and range of motion evaluation was performed to evaluate clinical outcomes. Plain radiographs at rest and with maximal pinch were performed to evaluate for arthroplasty space subsidence.

Results

The LRSA exhibited consistent clinical and functional outcomes throughout postoperative follow-up. As the average patient age and time from surgery increased, range of motion (ROM) and PRWHE scores stayed relatively constant, while lateral tip and tip pinch strength deteriorated with time. The LRSA prevented the proximal migration of the first metacarpal in all but one patient. No patients required revision arthroplasty following LRSA.

Conclusions

This study demonstrates the consistent short, intermediate, and long-term clinical, functional, and radiographic outcomes following a trapeziectomy with FCR suspension arthroplasty.

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Conflict of Interest

Mark A. Yaffe, Bennett Butler, James M. Saucedo, and Daniel J. Nagle have no conflicts of interest related to this study.

Statement of Human and Animal Rights

This study was IRB approved and was conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

Statement of Informed Consent

All subjects involved in this study understood and signed IRB-approved informed consent forms.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 1350, Chicago, IL, 60611, USA

    Mark A. Yaffe, Bennet Butler, James M. Saucedo & Daniel J. Nagle

Authors
  1. Mark A. Yaffe
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  2. Bennet Butler
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  3. James M. Saucedo
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  4. Daniel J. Nagle
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Corresponding author

Correspondence to Mark A. Yaffe.

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Grants

This study received funding from the Mid-America Orthopaedic Association in the form of a resident research grant.

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Yaffe, M.A., Butler, B., Saucedo, J.M. et al. First carpometacarpal arthroplasty with ligamentous reconstruction: a long-term follow-up. HAND 9, 346–350 (2014). https://doi.org/10.1007/s11552-014-9606-1

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  • DOI: https://doi.org/10.1007/s11552-014-9606-1

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