BASAL JOINT ARTHRITIS - TRAPEZIECTOMY WITH LIGAMENT RECONSTRUCTION AND TENDON INTERPOSITION ARTHROPLASTY

This article provides a qualitative and quantitative outcomes assessme nt of a consecutive series of 27 patients (30 thumbs) with basal joint arthritis of the thumb undergoing ligament reconstruction and tendon interposition arthroplasty. Outcome analysis revealed that 24 (89%) pa tients were satisfied with the relief of pain provided by the arthropl asty and 23 (87%) would undergo surgery again. Eighteen (67%) thumbs w ere noted to have improvement in the ability to perform activities of daily living. Significant improvements were noted in web space measure ments and in grip and pinch strength determination. X-ray film assessm ent using the trapezial space ratio averaged 0.33 +/- 0.08 in preopera tive x-ray films of thumbs with stage III and IV degenerative arthriti s and 0.23 +/- 0.07 in thumbs following basal joint arthroplasty. This represents a total decrease of 51% in the trapezial space ratio follo wing arthroplasty compared to the normal values obtained in previous s tudies and 33% compared to the preoperative values obtained in this st udy. Outcomes assessment at a mean of 42 months after surgery showed t hat there was no significant correlation between maintenance of trapez ial height and both objective and subjective clinical outcomes. Althou gh ligament reconstruction consistently failed to restore trapezial he ight, primary and secondary clinical outcomes following basal joint ar thritis were almost uniformly satisfactory.