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J Wrist Surg
DOI: 10.1055/s-0044-1791540
Scientific Article

Rates of Early Recovery Following Thumb Carpometacarpal Arthroplasty: Comparing Ligament Reconstruction and Tendon Interposition, Abductor Pollicis Longus Suspensionplasty, and Suture Button Suspensionplasty

Lawrence J. Lin 
1   Department of Orthopedic Surgery, NYU Langone Health, New York
,
Walter Sobba
1   Department of Orthopedic Surgery, NYU Langone Health, New York
,
Sophia Jacobi
1   Department of Orthopedic Surgery, NYU Langone Health, New York
,
Nader Paksima
1   Department of Orthopedic Surgery, NYU Langone Health, New York
,
S. Steven Yang
1   Department of Orthopedic Surgery, NYU Langone Health, New York
› Author Affiliations Funding The authors received no financial support for the research, authorship, and/or publication of this article.
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Abstract

Background Several techniques have been previously described for the treatment of thumb carpometacarpal (CMC) arthritis, including trapeziectomy with ligament reconstruction and tendon interposition (LRTI), abductor pollicis longus suspensionplasty (APLS), or suture button suspensionplasty (SBS). It remains unclear whether a specific method produces faster recovery and more rapid return to function. The purpose of this study was to evaluate early clinical outcomes in patients undergoing thumb CMC arthroplasty stratified by method of treatment.

Methods This study was conducted using a registry of patients undergoing thumb CMC arthroplasty using LRTI, APLS, or SBS. Patients were grouped by technique for comparison. Patient-reported outcomes were measured using Patient-Reported Outcome Measurement Information System (PROMIS) Upper Extremity, Pain Interference, and Pain Intensity scores and compared across cohorts using analysis of variance. Regression analysis was used to determine factors associated with early clinical outcomes.

Results Note that 150 out of 201 patients met inclusion criteria for this study. Univariate regression demonstrated no difference between technique and achievement of minimal clinically important difference (MCID) by 1 year or ∆PROMIS scores at 1 and 3 months postoperatively. Stepwise multivariate regression analysis also found that technique did not contribute significantly to postoperative outcomes. Increased baseline PROMIS Upper Extremity scores were associated with lower odds of achieving MCID (odds ratio 0.80, p < 0.001). Baseline PROMIS scores were also associated with ∆PROMIS scores at 1 and 3 months postoperatively.

Conclusion Patients undergoing thumb CMC arthroplasty via LRTI, APLS, or SBS can expect to experience similar improvements from baseline in the early postoperative period regardless of technique choice.

Keywords

thumb carpometacarpal arthritis - thumb carpometacarpal arthroplasty - ligament reconstruction and tendon interposition - abductor pollicis longus suspensionplasty - suture button suspensionplasty

Informed Consent

This study was determined to be exempt from the Institutional Review Board. Informed consent was not obtained as this was a deidentified database study that is open to use by participating institutions.




Publication History

Received: 14 May 2024

Accepted: 05 September 2024

Article published online:
03 October 2024

© 2024. Thieme. All rights reserved.

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