Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) for trapeziometacarpal joint osteoarthritis may have both postoperative benefits and complications. This study sought to determine the health state utility outcome measures of trapeziectomy with LRTI. Patients who underwent trapeziectomy with LRTI were invited to complete the brief Michigan Hand Questionnaire and utility questionnaires outcomes using a visual analogue scale , time trade-off and standard gamble. Quality-adjusted life years (QALYs) were derived from these utility measures. For this study 32 patients were recruited, with a mean age of 61. Most patients (27/32) perceived the procedure as successful. Utility measures and QALYs serve the purpose of comparing different surgical procedures in terms of their impact on the quality of life of patients as a function of the benefits and complications of each procedure. In this study, the utility of trapeziectomy with LRTI was less than has been described for open palmar fasciectomy but more than for total wrist arthrodesis. IV.
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Suture Suspensionplasty Compared With Ligament Reconstruction and Tendon Interposition for Surgical Treatment of Thumb Carpometacarpal Arthritis.
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University of Pittsburgh Medical Center Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Purpose: Thumb carpometacarpal (CMC) arthritis is the most common arthritis of the hand, with most studies demonstrating little difference in outcomes between various surgical treatment techniques. However, trapeziectomy, followed by ligament reconstruction and tendon interposition (LRTI), remains the technique of choice among hand surgeons in the United States. In 2009, suture suspensionplasty (SS) was first described as a less invasive alternative to LRTI.
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The purpose of this study was to conduct an updated survey of American Society for Surgery of the Hand (ASSH) membership to evaluate current preferences for surgical management of thumb CMC arthritis. Past surveys have demonstrated LRTI to be the most preferred surgical technique. We hypothesised that current surgical preferences for thumb CMC arthritis have changed over the last several years due to rising popularity of high-strength suture implants.
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Hand Surgery Unit, Department of Plastic Surgery, St Vincent's Hospital, Melbourne, Australia; Victorian Hand Surgery Associates, Melbourne, Australia; Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, St Vincent Institute, Melbourne, Australia; Department of Biomedical Engineering, University of Melbourne, Parkville, Australia; Department of Surgery, Monash University, Clayton, Australia. Electronic address:
Article Synopsis
- The study aimed to assess the long-term effects of trapeziectomy and ligament reconstruction with tendon interposition (LRTI) in patients under 56 years suffering from trapeziometacarpal osteoarthritis.
- It involved a retrospective analysis of 105 patients, with 48 returning for follow-up assessments, measuring pain and hand function over a mean period of 11 years post-surgery.
- Results indicated that while the procedures are generally effective, there is a deterioration in patient-reported outcomes and pain levels over time, suggesting the need to weigh the benefits against long-term effects.
Simple trapeziectomy for thumb basal joint arthrosis. Forty-four thumbs re-reviewed after 7.5 years.
J Hand Microsurg
August 2024
Dept. of Orthopedic Surgery, St.Olav's University Hospital, N-7006, Trondheim, Norway.
Background: Due to favorable results in the literature we changed our standard procedure in 2010 from trapeziectomy with LRTI to simple trapeziectomy for thumb basal joint arthrosis. A review of 49 operated hands after two years showed good results, similar to those we had obtained after LRTI.
Objective: We have now re-reviewed these patients to see if the good results persist over time.
A Prospective Randomized Pilot Study: One-Year Outcomes of Ligament Reconstruction Tendon Interposition Versus Suture Tape Suspensionplasty for Thumb Carpometacarpal Joint Arthritis.
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Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO. Electronic address:
Purpose: We performed a randomized controlled trial assessing patient-reported outcome measures following trapeziectomy with ligament reconstruction and tendon interposition (LRTI) or suture tape suspensionplasty (STS) for treatment of thumb carpometacarpal joint osteoarthritis.
Methods: Patients undergoing surgery for thumb carpometacarpal joint osteoarthritis were prospectively randomized to LRTI or STS. Outcome measures were collected at 2 weeks, 4 weeks, 3 months, and 1 year and included visual analog scale pain, Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity, return to work/activity, range of motion, grip/pinch strength, and complications.
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