Ligament reconstruction suspension arthroplasty using double looped palmaris longus tendon graft with suture button for advanced thumb carpometacarpal arthritis: Minimum 5 years follow-up

Background
This study was performed to assess the clinical and radiographic results at a minimum of 5 years after ligament reconstruction suspension arthroplasty (LRSA) that comprised total trapeziectomy and suspensionplasty using double looped palmaris longus tendon graft with suture button (Mini TightRope, Arthrex, Naples, FL) for advanced thumb carpometacarpal arthritis (Fig. 1, 2).  

Methods
22 thumbs in 19 patients who had undergone LRSA at least 5 years previously were evaluated clinically and radiographically. The mean follow-up period was 68.5 months. The subjective clinical outcomes (visual analogue scale (VAS) for pain and Disabilities of the Arm, Shoulder, and Hand (DASH) scores) and objective clinical outcomes (range of motion, pinch strength, grip strength, and trapezial space height ratio) were evaluated.  

Results
The mean VAS score was significant decreased from 34.5 to 5.6 (resting), and from 76.4 to 9.6 (working), respectively. The mean DASH questionnaire score also significant improved from 35.9 to 13.7. The mean radial and palmar abduction were maintained from 51.1° to 46.6° and from 53.4° to 44.2°, respectively. The mean key pinch and grip strength were improved significantly from 3.4kg to 4.8kg and from 18.2kg to 21.3kg, respectively.  

Conclusions
LRSA for advanced-stage thumb carpometacarpal arthritis relieves pain, improves range of motion and strength, and obtains favorable subjective patient-reported clinical outcomes over the long term without complications.  

References
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