LIGAMENT RECONSTRUCTION BASAL JOINT ARTHROPLASTY WITHOUT TENDON INTERPOSITION

The necessity of tendon interposition for the maintenance of joint spa ce after basal joint resection arthroplasty with ligament reconstructi on has not been established. A prospective, randomized study was perfo rmed. In Group I (nine patients), ligament reconstruction was performe d to suspend the first metacarpal in addition to placement of a rolled tendon interposition to fill the void created by resection of the tra pezium. In Group II (11 patients), ligament reconstruction alone was p erformed, with use of a Mitek suture anchor. No tendon interposition w as performed. This allowed use of a more limited incision and shorter length of tendon graft. Average followup was 23 months. There was no d ifference between the two groups in range of motion of the thumb, grip strength, lateral pinch strength, the ability to perform activities o f daily living, or subjective satisfaction with the procedure. Two- an d three-point pinch strength was statistically significantly greater i n Group II. Lateral radiographs of the basal joint at foIlowup, at res t and with pinch, showed maintenance of the joint space, and no differ ence between the two groups. Tendon interposition is not necessary for maintenance of joint space after basal joint resection arthroplasty i f ligament reconstruction is performed.