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Mean 5 Year Followup Following Tightrope Suspensionplasty for Thumb Carpometacarpal Joint Arthritis
Jeffrey Yao, MD; Andre Cheah, MD
Stanford University, Palo Alto, CA
Purpose: Suture-button suspensionplasty (SBS) has been used to treat thumb carpometacarpal joint osteoarthritis (CMCJ OA). While promising short and medium term outcomes have been reported, no longer-term outcome studies have been published. The aim of this manuscript is to report the longer-term outcomes of SBS and comment on the longevity of the procedure.
Methods: We reviewed the charts of 14 patients who underwent 16 SBS procedures for symptomatic thumb CMCJ OA. We recorded demographic data, pre-operative Eaton stage, length of follow-up, Quick Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire scores as well as pinch strength, grip strength, range of motion and metacarpal subsidence. In addition, operative time and postoperative complications were documented.
Results: The average age of our patients was 64 years. There were 12 females and 2 males. Pre-operative Eaton stages were III and IV in 8 thumbs each. Mean total operative time was 93 minutes. Mean follow-up was 64 months with mean improvement of quick DASH score of 58.2. Mean radial and palmar abduction was 97% and 105% of the non-operated thumb respectively. Kapandji scores for all of the operated thumbs were either 9 or 10. Pinch strength and grip strength was 119% and 110% of the non-operated side, respectively. Mean trapezial space height was 71%. One patient underwent removal of a symptomatic implant and two patients were diagnosed with transient neuropraxia of the dorsal radial sensory nerve.
Conclusion: The outcomes of SBS remain durable over time, and our results show that improvement of strength may also be expected over time when utilizing SBS following trapeziectomy for the treatment of thumb CMCJ OA.
Clinical Relevance: This study provides evidence to suggest that favorable longer-term outcomes may be expected when SBS is used to treat thumb CMCJ OA.
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