Outcomes of Suture Suspension Arthroplasty in the Treatment of Basal Joint Arthritis
Laura Klingbeil, DO1; M Ather Mirza, MD2; Justin Mirza, DO3; Joseph Pavlik III, BS2; Jonathan Muratori, BS2
1Plainview Hospital, Plainview, NY, 2Mirza Orthopedics, Smithtown, NY, 3North Shore Surgi-Center, Smithtown, NY
Purpose: To present a retrospective study on the outcomes of suture suspension arthroplasty with trapeziectomy on patients suffering from thumb basal joint arthritis and evaluate subsidence and its effect on patient outcome.
Methods: The surgical technique involves excision of the trapezium followed by suturing the flexor carpi radialis and the abductor pollicis longus together creating a sling for suspension and tendon interposition. We performed a chart review on 71 patients (80 cases) who underwent the procedure from May 2010 to May 2016. Outcome measures included Disabilities of the Arm, Shoulder and Hand, grip strength, lateral/precision pinch strength, range of motion, and return to work/ resumption of usual activities. Radiographic images were utilized to measure 1st metacarpal subsidence into the trapezial space as described by Kadiyala et al.1
Results: Clinical outcomes were satisfactory showing an initial DASH score of 45.94 which decreased to 27.93 at 6 month post-op and eventually even lower: 19.69 at 1 year post-op. Radiographic images revealed a mean first metacarpal subsidence of .118 cm from the pre-op average trapezial space ratio of .360 cm, which appears to be minimal in comparison to previous literature. Grip and pinch strengths showed steady improvement from initial post-op to final follow-up (14 months).
Conclusions: Our study has found that trapeziectomy and suture suspension arthroplasty is an effective treatment for thumb basilar joint arthritis. SSA allows for shorter immobilization time, avoids tendon sacrifice, avoids anchor use, allows minimal subsidence, and can be performed in an efficient manner compared to other techniques. Further, there does not appear to be a relationship of any significance between post-op first metacarpal subsidence and grip strength recovery or DASH.
Pre-op Trapezial Space Post-op trapezial Space
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