Trapeziectomy with ligament reconstruction and tendon interposition arthroplasty continuously improves hand functions up to 5-year postoperatively.

Abstract

Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty is a reliable surgical procedure for the treatment of thumb carpometacarpal osteoarthritis, which provides good long-term outcomes. However, it remains unclear when the greatest benefit of this procedure can be obtained, and how long these benefits will continue. Therefore, we investigated the middle- to long-term advantages of this procedure by analysing the chronological changes in clinical outcomes by following the same patients from 1year to a median 5years after trapeziectomy with LRTI. Sixteen thumbs that completed consecutive clinical and radiographic evaluations preoperatively, 1year, 2years, 3years, and median 5years (range 4-8years) after trapeziectomy with LRTI were included in this study. We investigated grip strength, pinch strength, range of motion (ROM) of the thumb, a visual analogue scale for pain, Disabilities of Arm, Shoulder and Hand (DASH) score, Hand20 questionnaire score, trapezial space height, and trapezial space ratio at every time point. Hand strength (grip, pulp, and lateral pinch), palmar abduction, DASH score, and Hand20 questionnaire score were improved at 1year postoperatively while the radial abduction showed significant improvement at the final follow-up. Moreover, pulp pinch strength, DASH score, and Hand20 questionnaire score continued to improve significantly from 1year postoperatively to the final follow-up. Conversely, trapezial space height and ratio continuously decreased up to the final follow-up. Trapeziectomy with LRTI consecutively improved the pinch strength, ROM of the thumb, DASH score, and Hand20 questionnaire score up to 5years postoperatively. It also maintained the improvement of the other clinical outcomes up to 5years postoperatively except for radiological findings.