APL to FCR Tenodesis Suspensionplasty in Addition to Mini Tightrope Suspensionplasty and Trapeziectomy for Basal Joint Osteoarthritis: Clinical and Radiological Outcomes

Abstract

Purpose

This study aims to compare the clinical and radiological outcomes of adding FCR-APL tenodesis to suture-button suspensionplasty following trapeziectomy in the treatment of Basal Joint Osteoarthritis (BJOA).

Methods

This study is based on a prospectively collected cohort, comparing patients treated with trapeziectomy and suture-button suspensionplasty, with (n=14) or without (n=18) additional APL-FCR suspensionplasty, followed until one month postoperatively. Mid-term outcomes were assessed through retrospective analysis of 29 patients who returned for a routine follow-up more than 12 months after surgery. Outcomes included trapezial space ratio (TSR), patient-reported pain (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), range of motion (ROM), and return-to-work time.

Results

Both groups demonstrated significant improvements in pain and all functional outcomes, with no significant difference between the groups in DASH, PRWE, and VAS scores as well as in ROM limitation or return-to-work time. TSR reduction was observed in both groups, but there was no significant difference in subsidence between the two. Minor complications occurred in both groups.

Conclusions

Both surgical techniques improved patient-reported outcomes. However, the addition of APL-FCR suspensionplasty to suture-button suspensionplasty did not significantly reduce the subsidence of the first metacarpal bone or improve functional results.

Zusammenfassung

Hintergrund

Diese Studie zielt darauf ab, die klinischen und radiologischen Ergebnisse einer FCR-APL Tenodese zusätzlich zur Suture-Button-Suspensionplastik nach Trapeziektomie bei der Behandlung der Rhizarthrose (RA) zu untersuchen.

Methoden

Diese Studie basiert auf einer prospektiv gesammelten Kohorte, die Patienten mit Trapeziektomie und Suture-Button-Suspensionplastik, welche mit (n=14) oder ohne (n=18) zusätzlicher APL-FCR-Suspensionplastik behandelt wurden, mit einem Follow up 1 Monat nach der Operation vergleicht. Mittelfristige Ergebnisse wurden durch eine zusätzliche retrospektive Analyse von 29 Patienten erhoben, die mehr als 12 Monate nach der Operation zu einer routinemäßigen Nachsorge zurückkehrten. Die Ergebnisse umfassen das Trapezraum-Verhältnis (TSR), Schmerz (VAS), Disabilities of the Arm, Shoulder, and Hand-Score (DASH), Patient-Rated Wrist Evaluation (PRWE)-Score, Bewegungsumfang (ROM) und Rückkehr zur Arbeit.

Ergebnisse

Beide Gruppen zeigten signifikante Verbesserungen hinsichtlich Schmerzen und allen funktionellen Ergebnissen, ohne signifikante Unterschiede zwischen den Gruppen hinsichtlich DASH-, PRWE- und VAS-Werten, noch der ROM-Einschränkung oder der Rückkehr zur Arbeit. Eine Reduktion des TSR wurde in beiden Gruppen beobachtet, jedoch gab es keinen signifikanten Unterschied hinsichtlich der Sinterung des Daumenstrahls zwischen den beiden. In beiden Gruppen traten geringfügige Komplikationen auf.

Schlussfolgerungen

Beide chirurgischen Techniken verbesserten die vom Patienten berichteten Ergebnisse, jedoch reduzierte die Hinzunahme der APL-FCR-Suspensionplastik zur Suture-Button-Suspensionplastik nicht die Sinterung des 1. Mittelhandknochens und brachte keine Vorteile hinsichtlich der funktionellen Ergebnisse.

Keywords

Trapeziectomy - Trapezial space ratio - APL to FCR tenodesis - Tenodesis suspensionplasty - Basal joint arthritis - Hand surgery - Resection-suspension arthroplasty - Thumb - Tendon

Schlüsselwörter

Trapezektomie - APL-FCR-Tenodese - Suspension - Arthrose des Daumensattelgelenks - Handchirurgie - Resektionsarthroplastik - Daumen - Sehne

Publication History

Received: 17 June 2024

Accepted: 05 March 2025

Article published online:
30 May 2025

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