Results of arthroscopic partial trapeziectomy with suture-button suspensionplasty for thumb carpometacarpal arthritis

Arthroscopic arthroplasty with suture-button suspensionplasty has been developed and predictable results have been reported. To date, however, few studies have reported that this procedure improves the range of motion (ROM) of the thumb carpometacarpal joint. The purpose of this study represents the clinical results, especially ROM improvement, of arthroscopic partial trapeziectomy with suture-button suspensionplasty for symptomatic grade Ⅱ and Ⅲ thumb carpometacarpal arthritis with a minimum one year follow-up.

Thirty-nine cases of thumb carpometacarpal arthritis (grade Ⅱ and Ⅲ) in which conservative treatment was ineffective were included (mean age 69.0 years, 48 to 84 years old). Postoperative observation was more than one year. Twenty-eight patients are female and eleven are male. The surgical method is partial resection of the distal trapezium articular surface under carpometacarpal arthroscopy and suture-button suspensionplasty between the first metacarpal base and the second metacarpal shaft. Postoperative treatment is one week immobilization and to start active range of motion exercise. The physical assessments included ROM, pain visual analogue scale (VAS), strength, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire before surgery and at final follow-up. The Wilcoxon signed-ranked test was used to analyze the VAS results before surgery with those at final examination. Paired t tests were used to compare the other assessment results. Statistical significance was set at p < .05.

Preoperative VAS score (70.5±13.5) significantly reduced at the final follow-up (10.9±13.0). Preoperative radial abduction and palmar abduction (45.4±14.9° and 51.4±13.9°, respectively) significantly increased at the final follow-up (58.2±15.9° and 63.4±14.0°, respectively). Preoperative percentages of pinch strength (57.6±26.9%) significantly increased at the final follow-up (84.8±41.4%).Preoperative DASH score (39.3±16.4) significantly improved at the final follow-up (11.0±9.2).

An arthroscopic partial trapeziectomy with suture-button suspensionplasty is considered an effective treatment with significant pain relief and preserving joint motion.

Keywords: thumb carpometacarpal arthritis, suture-button suspensionplasty, arthroscopy, partial trapeziectomy