Outcomes of Suture Suspension Arthroplasty in the Treatment of Basilar Joint Arthritis
Justin Mirza, MD; M Ather Mirza, MD
Mirza Orthopedics, Smithtown, NY
Although several procedures have been described for thumb basilar joint arthritis, no specific surgery has shown to be superior. In this study, we describe and report on the outcomes of a novel technique using suture suspension arthroplasty (SSA) in the treatment of thumb basilar joint arthritis. Additional attention was also given to recession of the first metacarpal and assessment of the distance of the collapse between the 1st metacarpal and the scaphoid.
The surgical technique involves trapeziectomy under fluoroscopic assistance, followed by passing a suture through the abductor pollicis longus and flexor carpi radialis in order to create a suture suspension sling construct to maintain joint space and soft tissue tension. A retrospective chart review was performed on 60 patients in a 6 year period with a mean follow up of 14 months. X-ray analysis to determine 1st metacarpal subsidence was done by measuring the trapezial space ratio as defined by Kadiyala et al (1996). DASH Scores were obtained to determine patient satisfaction.
Preliminary clinical outcomes for 60 patients treated with suture suspension arthroplasty (average follow-up of 14 months) were satisfactory, with an average initial follow-up DASH score of 45.94, 8-12 week score of 55.41, 6 month score of 29.93, 1 year score of 25.15, and final follow-up score of 25.74. The average pre-op trapezial space ratio was 0.337 with an average decrease of 0.116 after surgery.
Our study has found that Trapeziectomy and suture suspension arthroplasty is an effective treatment option for thumb basilar joint arthritis when compared to other arthroplasty techniques. SSA allows for shorter immobilization, avoids sacrificing a tendon or using anchors, and can be performed in an efficient manner. Further, minimal subsidence of the 1st metacarpal was experienced using the SSA technique.
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