Ligament Reconstruction of the Trapezial-metacarpal Joint for Early Arthritis: A Preliminary Report

PurposeTo evaluate the results and determine the efficacy of an alternative ligament reconstruction technique in patients with a symptomatic trapezial-metacarpal joint associated with subluxation and early or limited chondral damage.MethodsThis retrospective, nonrandomized study was composed of 6 patients, all women with ages between 31–46 years, treated by arthroscopic evaluation and reconstruction of the intermetacarpal and reverse anterior oblique ligament of the trapezial-metacarpal joint, using a strip of flexor carpi radialis tendon. Evaluation at an average follow-up of 18 months (range,12–28 mo) consisted of interview, examination, and computed tomography.ResultsThe visual analog pain score, preoperative rest pain, and activity pain improved significantly after surgery. Tip and lateral pinch strength measured 92% compared to the contralateral thumb, and computed tomography showed improved alignment of all joints.ConclusionsOur results indicate that ligament reconstruction using the technique described reduced pain, increased strength, and improved the trapezial-metacarpal joint alignment in patients with early symptomatic trapezial-metacarpal joint osteoarthritis associated with joint subluxation.Type of study/level of evidenceTherapeutic IV.