Intraoperative Load Tolerance of the Thumb Carpometacarpal Joint After Resection-Suspension-Interposition Arthroplasty

Basal thumb arthritis surgery: complications and its management

The management of complications after surgery for basal thumb arthritis is sometimes challenging, and there are no clear recommendations on how to evaluate and manage patients with residual symptoms. The aim of the present article was to review the most common complications after surgery for basal thumb arthritis, with an emphasis on resection arthroplasty, joint replacement and joint fusion. In addition, possible management strategies for the different types of complications will be highlighted.

Biomechanical Comparison of FiberLock Suspensionplasty and Flexor Carpi Radialis Ligament Reconstruction for Treatment of Thumb Carpometacarpal Osteoarthritis

BACKGROUND

The purpose of this study was to compare the cyclic and load to failure characteristics of post-trapeziectomy suspensionplasty with the FiberLock Suspension System (FLSS; Arthrex Inc., Naples, Florida) to flexor carpi radialis ligament reconstruction (FCRLR). We hypothesized that the FLSS will have increased stiffness, yield, and ultimate load compared with FCRLR.

METHODS

Ten matched pairs of cadaveric hands were used. One side of each pair was randomly assigned to receive the FCRLR or FLSS and the contralateral side received the other suspensionplasty. A complete trapeziectomy was performed followed by FLSS or FCRLR. Cyclic and load to failure characteristics were measured with loading in the distal to proximal direction. A preload of 1 N with 30 cycles of 1 N to 10 N was applied, followed by load to failure. A paired t test was used for statistical analysis (P < .05).

RESULTS

The FLSS had significantly decreased nonrecoverable deformation and deformation at peak load during cyclic loading (P < .04). The FLSS also had significantly increased stiffness, yield load, ultimate load, and load and energy absorbed at 10 mm displacement compared with FCRLR (P < .04). All 10 FCRLR specimens failed with suture tearing through the tendon. Nine FLSS specimens failed due to suture slipping from the SwiveLock anchor (Arthrex Inc., Naples, Florida) and 1 failed due to the FiberTak anchor (Arthrex Inc., Naples, Florida) pulling through the index metacarpal.

CONCLUSION

Suspensionplasty with the FLSS demonstrated greater structural integrity compared with FCRLR following trapeziectomy. The FLSS procedure may result in decreased thumb subsidence and decreased construct failure.