Thumb Pain Research Articles

Trapeziometacarpal Arthritis: A Prospective Clinical Evaluation of the Thumb Adduction and Extension Provocative Tests

To determine the diagnostic performance (ie, sensitivity, specificity, interrater reliability) of the thumb metacarpal adduction and extension tests against traditional examination maneuvers for trapeziometacarpal (TMC) arthritis. This cross-sectional study recruited 129 patients from 2 outpatient offices at a tertiary institution. All patients had radiographic wrist examinations and completed a standardized physical examination consisting of the thumb adduction and extension tests as well as standard examination maneuvers for radial wrist and thumb pain. The physical examinations were performed by 1 of 2 attending physicians and an independent examiner. Patients were recruited for 3 diagnostic groups: TMC arthritis, radial wrist or hand pain, and nonradial wrist pain controls. Statistical analysis calculated the sensitivity, specificity, and interrater reliability of each physical examination maneuver for detecting TMC arthritis. The thumb adduction maneuver was found to have a sensitivity of 0.94 (confidence interval [CI], 0.82-0.98) and a specificity of 0.93 (CI, 0.86-0.97). The thumb extension maneuver had a sensitivity of 0.94 (CI, 0.82-0.98) and a specificity of 0.95 (CI, 0.87-0.98). The interrater reliability was excellent for both the adduction (κ = 0.79) and the extension tests (κ = 0.84). The grind test had a sensitivity of 0.44 (CI, 0.30-0.59), a specificity of 0.92 (CI, 0.84-0.97), and poor interrater reliability (0.31). Point tenderness at the TMC joint had a sensitivity of 0.94 (CI, 0.82-0.98), a specificity of 0.81 (CI, 0.71-0.88) and fair interrater reliability (κ = 0.63). The adduction and extension tests each proved to be more sensitive than the grind test for the detection of TMC arthritis. Further, these provocative tests were more specific for basal joint arthrosis than was the elicitation of point tenderness at the joint. The metacarpal adduction and extension maneuvers demonstrated excellent utility as screening tests for the identification of TMC arthritis. Diagnostic II.

Thumb Carpometacarpal Joint Resurfacing With Autologous Ear Cartilage

A study was designed to ascertain the long-term effectiveness of using autologous full-thickness ear cartilage to resurface the arthritic face of the trapezium, leaving the body of the trapezium intact. The value of injection of the involved carpometacarpal (CMC) joint with local anesthetic in predicting improvement from the surgery was also studied. An operation was used to enter the CMC joint of the thumb between the thenar muscles and the abductor tendon. The articular surface of the trapezium was resected and resurfaced with full-thickness ear cartilage from the patient's ear. Patients were selected based on constant, unremitting pain. All patients also had x-ray evidence of severe arthritis at the CMC joint of the thumb. Both thumbs were evaluated for pain, range of motion, key and palmar pinch, and grip strength before the surgery and followed up for a minimum of 30 months to be included in the study. Fifty-nine patients had ear cartilage arthroplasty from 1997 to 2007 by the same surgeon with a total of 67 operations (8 patients, all women, had both thumbs operated). Forty-nine of these patients, 4 men and 45 women (53 hands), were available for follow-up and constitute the study group. Eight procedures were done on the left hand, and 45, on the right. There were no ear complications and no cartilage extrusions. All patients had improved range of motion and greatly decreased pain. Strength was equaled or exceeded the unoperated thumb. Preoperative joint injection was a good predictor of postoperative pain relief. All patients were pleased with the result and said that they would have the surgery again. Thumb CMC joint arthroplasty with autologous ear cartilage and preservation of the body of the trapezium is an effective alternative to existing procedures.There is no morbidity to the ear, and predictable long-term improvement in thumb pain and strength can be obtained. Injection of the CMC joint before surgery with local anesthetic is a reliable predictor of improvement from surgery.

Increased range of motion and decreased strength of the thumb in massage practitioners with thumb pain.

The purpose of this study was to compare the range of motion (ROM) and strength of the metacarpophalangeal (MP) and interphalangeal (IP) joints among massage practitioners with and without thumb pain and control subjects. Sixteen massage practitioners with thumb pain, 16 practitioners without thumb pain, and 16 control subjects participated in this study. ROM of flexion, extension, and abduction in the MP joint; ROM of flexion and extension in the IP joint of the thumb; strength of the flexor pollicis brevis (FPB), extensor pollicis brevis (EPB), abductor pollicis brevis, flexor pollicis longus (FPL), and extensor pollicis longus measured in all subjects. ROM of extension and abduction in the MP joint were significantly increased in massage practitioners with and without thumb pain compared with control subjects. ROM of extension in the IP joint was significantly increased in massage practitioners with thumb pain compared with those without thumb pain. The strength of the EPB and FPL muscle was significantly decreased in massage practitioners with thumb pain compared with those without thumb pain and control subjects, respectively. In addition, there was significantly increased EPB/FPB strength in massage practitioners without thumb pain compared to those with thumb pain and control subjects.

Frequency of De Quervain�s tenosynovitis and its association with SMS texting

to assess the frequency of De Quervain's tenosynovitis and its association with SMS texting. a cross-sectional survey was conducted among undergraduate students studying in different physical therapy schools of Karachi belonging to both public and private sectors. Sample size was 300 students which were selected through convenience sampling. Data was collected through self-administered questionnaire and severity of the pain was assessed through Universal Pain Assessment Tool and De Quervain's tenosynovitis was diagnosed through Finkelstein test. Data entry and analysis were done using computer software SPSS version 20. Frequency and percentages were taken for categorical variable. Chi-square was applied to determine association between different variables and Finkelstein test. P value < 0.05 was considered significant. male/female ratio was 1:4. Regarding the use of cell phones, majority 165 (55%) were using regular cell phones, another 89 (30%) were using touch screen and 38 (13%) were using QWERTY key pads. Almost half of the students were frequently using cell phones for texting, out of them 132 (44%) texted less than 50 messages per day. Another 96 (32%) did texting between 50-100 texts. Out of 300 students who filled the questionnaire 125 (42%) students were experiencing pain in the thumb/wrist. Finkelstein test when done on students almost half (n=149) showed positive results. It was noted that as frequency of mobile phone usage increased progressively more and more people showed positive Finkelstein Test (p value 0.000). the result of the study concluded that almost half of the students use their mobile phones for texting more than 50 S.M.S per day and because of their mobile key pads and high speed of texting they experienced pain and weakness over the base of the thumb/wrist which shows the De Quervain's positive in that students and there is a positive association between the thumb pain and frequent text messaging.

Extensor Pollicis Longus Injury in Addition to De Quervain's with Text Messaging on Mobile Phones.

To do a clinical and ultrasonic evaluation of subjects with thumb pain with text messaging. Thumbs are commonly used for text messaging, which are not as well designed for fine manipulative or dexterous work. Repetitive use as in text messaging can lead to the injury to the tendons of the thumb. Ninety eight students with symptoms of Repetitive Strain Type of injuries of the thumb were selected from a survey and evaluated both clinically and by ultrasound analysis of the musculotendinous unit of the thumb to note changes due to excessive use of the mobile phone. Age and sex matched controls were also subjected to ultrasound evaluation. Clinical examination showed positive Finkelstein test in 40% of the cases, significant reduction in the lateral and tip pinch strengths in the cases. Ultrasound detected changes in the first and the third compartments in 19% of the cases. Isolated cases of pain in the thumb have been reported but this study noted changes both clinically and by ultrasound in the tendons of the thumb. These changes should be taken as warning signs of possible subclinical changes taking place in the soft tissues of the thumb in these subjects due to repetitive use of mobile phones and thus, making them prone for developing painful Musculoskeletal Disorders. Repetitive use of mobile phones for text messaging can lead to the damage of Extensor pollicis longus of the thumb in addition to the tendons of the first compartment of the wrist.

Effects of a dynamic stability approach in conservative intervention of the carpometacarpal joint of the thumb: A retrospective study

Study designRetrospective cohort. IntroductionConservative intervention of carpometacarpal joint (CMC) thumb pain, caused by osteoarthritis and ligament laxity, is frequently seen in hand therapy. Traditional intervention for pain and disability reduction includes orthoses, exercises, and joint protection education. The literature on conservative management is unclear which design or program of exercises create an effective result. Results of a conservative dynamic stability interventional model for thumb pain are presented as a design which positively effects pain and disability. Purpose of the studyThe purposes were to primarily investigate change in pain and disability in persons with CMC pain in a dynamic stability modeled approach to intervention, and secondarily, to assess the average number of visits and the duration of total visits in this model. MethodsA retrospective chart review was completed on 35 charts of those seen at a multicenter hand therapy clinic. The pain and disability scores from the QuickDASH were used as outcome measures. ResultsThe average group pain and disability scores improved by 17.9% (p < .01) and 19.3% (p < .01) respectively, with average individual disability improvement of 15.7%, which is greater than the accepted MCID. The average patient visits were 2.37 over an average range of 44.5 days. The group demographics match current literature: 31 females to 4 males, with average age of 58 years (range of 30–82 years). ConclusionSignificant reduction in pain and disability is noted with a conservative dynamic stability modeled approach to intervention, with information on average visits and duration in this model of care for individuals with thumb pain at the CMC joint. Level of evidence4.

Lung cancer presenting as a metastasis to the carpal bones: a case report

IntroductionA first metastasis to the hand is extremely rare. Usually, an acrometastasis is a sign of very advanced disease, with the presence of previous multiple metastases elsewhere. The present paper is one of the very few case reports of first metastatic location to carpal bones. To date, only Lederer et al., in 1990, and Song and Yao in 2012, have described a metastasis to the trapezium from lung cancer.Case presentationA 74-year-old Caucasian man was submitted to several physical examinations for thumb pain. The first diagnosis was tendonitis and the second diagnosis was thumb carpometacarpal osteoarthritis. Only when the patient was admitted to an internal medicine department for deterioration of his general condition and an enormous mass on his left hand was an open biopsy performed. It revealed a metastasis from large-cell lung carcinoma. A total-body scintigraphy and total-body computed tomography scan were negative for other secondary locations. The patient underwent an amputation at the distal third of the forearm.ConclusionLess than 20 case reports are available in the literature dealing with metastases to carpal bones. Very few cases are described as carpal metastases in the absence of other previous metastases, and only two articles, before the present one, have reported a metastasis to the trapezium. This case report teaches us two things: first, patient adherence to follow-up is extremely important; and, second, a thorough examination of diagnostic findings needs to be carried out at all times.

Metastatic Lung Adenocarcinoma Presenting as Thumb Pain

Metastatic Lung Adenocarcinoma Presenting as Thumb Pain

A Three-Step Technique to Correctly Identify the Trapezium without the Need for Fluoroscopic Imaging

Thumb pain secondary to degenerative arthritis of the carpometacarpal joint of the thumb is a common disabling condition. The key principles of successful basal joint arthroplasty involve trapezial excision, which is required for pain relief, with or without some form of ligament reconstruction. The majority of basal joint reconstructive procedures include partial or complete trapeziectomy, with and without some types of tendon transfer and ligament reconstruction and with or without tendon interposition and/or temporary wire stabilisation. When performing a trapeziectomy, it is important to identify the trapezium correctly before excising it. Excision of the incorrect bone during trapeziectomy for basal joint arthritis of the thumb has been reported within the NHS Litigation Authority database. We describe the senior author's routinely used three-step technique to confirm the identity of the trapezium before excision. This technique has been reliably used in over 300 cases with successful excision of the trapezium without intraoperative fluoroscopy.

Prognostic value of thumb pain sensation in birth brachial plexopathy

To evaluate the prognostic value of absent thumb pain sensation in newborns and young infants with birth brachial plexopathy. We evaluated 131 patients with birth brachial plexopathy with less than two months of age. Pain sensation was evoked by thumb nail bed compression to evaluate sensory fibers of the upper trunk (C6). The patients were followed-up monthly. Patients with less than antigravity elbow flexion at six months of age were considered to have a poor outcome. Thirty patients had absent thumb pain sensation, from which 26 showed a poor outcome. Sensitivity of the test was 65% and specificity was 96%. Evaluation of thumb pain sensation should be included in the clinical assessment of infants with birth brachial plexopathy.

Five- to 18-Year Follow-Up for Treatment of Trapeziometacarpal Osteoarthritis: A Prospective Comparison of Excision, Tendon Interposition, and Ligament Reconstruction and Tendon Interposition

To investigate whether palmaris longus interposition or flexor carpi radialis ligament reconstruction and tendon interposition improve the outcome of trapezial excision for the treatment of basal joint arthritis after a minimum follow-up of 5 years. We randomized 174 thumbs with trapeziometacarpal osteoarthritis into 3 groups to undergo simple trapeziectomy, trapeziectomy with palmaris longus interposition, or trapeziectomy with ligament reconstruction and tendon interposition using 50% of the flexor carpi radialis tendon. A K-wire was passed across the trapezial void and retained for 4 weeks, and a thumb spica was used for 6 weeks in all 3 groups. We reviewed 153 thumbs after a minimum of 5 years (median, 6 y; range, 5-18 y) after surgery with subjective and objective assessments of thumb pain, function, and strength. There was no difference in the pain relief achieved in the 3 treatment groups, with good results in 120 (78%) patients. Grip strength and key and tip pinch strengths did not differ among the 3 groups and range of movement of the thumb was similar. Few complications persisted after 5 years, and these were distributed evenly among the 3 groups. Compared with the results at 1 year in the same group of patients, the good pain relief achieved was maintained in the longer term, irrespective of the type of surgery. While improvements in grip strength achieved at 1 year after surgery were preserved, the key and tip pinch strengths deteriorated with time, but the type of surgery did not influence this. The outcomes of these 3 variations of trapeziectomy were similar after a minimum follow-up of 5 years. There appears to be no benefit to tendon interposition or ligament reconstruction in the longer term.

The Effect of an Open Carpal Tunnel Release on Thumb CMC Biomechanics

Purpose. We have observed worsening thumb pain following carpal tunnel release (CTR) in some patients. Our purpose was to determine the effect of open CTR on thumb carpometacarpal (CMC) biomechanics. Methods. Five fresh-frozen cadaver arms with intact soft tissues were used. Each specimen was secured to a jig which fixed the forearm at 45° supination, and the wrist at 20° dorsiflexion, with thumb pointing up. The thumb was axially loaded with a force of 130 N. We measured 3D translation and rotation of the trapezium, radius, and first metacarpal, before and after open CTR. Motion between radius and first metacarpal, radius and trapezium, and first metacarpal and trapezium during loading was calculated using rigid body mechanics. Overall stiffness of each specimen was determined. Results. Total construct stiffness following CTR was reduced in all specimens but not significantly. No significant changes were found in adduction, pronation, or dorsiflexion of the trapezium with respect to radius after open CTR. Motion between radius and first metacarpal, between radius and trapezium, or between first metacarpal and trapezium after open CTR was not decreased significantly. Conclusion. From this data, we cannot determine if releasing the transverse carpal ligament alters kinematics of the CMC joint.

Effects of taping on thumb alignment and force application during PA mobilisations

Work related thumb pain (WRTP) is a major problem among manipulative physiotherapists. Therapists who maintain the thumb joints in an extended alignment during PA mobilisation experience less WRTP. The purposes of this study were to investigate what effect taping of the thumbs has on thumb alignment during mobilisation and to gain normative data on the mobilisation forces applied by student physiotherapists. Forty final year student physiotherapists participated and were asked to apply a grade III PA mobilisation onto the C7 vertebra of one of 32 asymptomatic models. Participants were then instructed to apply the same mobilisation onto a force measurement instrument, in both the tape and no tape conditions, while the alignment of their metacarpophalangeal (MCP) and interphalangeal (IP) joints was noted via video recorder. Thumb alignment improved in 72.5% of participants post taping, with significant increases in the number of MCP joints maintained in a neutral alignment (p < 0.05). The mean peak mobilisation force applied by the students was 70.9 N. Taping of the thumbs prior to PA mobilisation improved thumb alignment during mobilisation in this cohort of undergraduate students, thus potentially influencing one of the contributory factors to WRTP.

Radiographic thumb osteoarthritis: frequency, patterns and associations with pain and clinical assessment findings in a community-dwelling population

Objectives. The aim of this study was to investigate: (i) the frequency and patterns of radiographic OA (ROA) in the thumb joints; and (ii) associations between thumb ROA and the clinical characteristics of thumb OA in older adults with hand pain or problems.Methods. Participants were 592 community-dwelling older adults with hand pain or hand problems who attended a research clinic. Hand X-rays were taken and 32 joints were scored for the presence of ROA. The occurrence and pattern of ROA in the hand were examined. Univariable and multivariable associations of thumb pain and clinical assessments (nodes, deformity, enlargement, thenar muscle wasting, grind test, Kapandji index, Finkelstein’s test and thumb extension) with ROA were investigated.Results. The first CMC and thumb IP joints were the hand joints most frequently affected with ROA. The thumb (thumb IP, first MCP, first CMC, trapezioscaphoid) was the most commonly affected joint group (n = 412). Isolated thumb ROA occurred more frequently than in any other isolated joint group. Multivariable analyses showed that older age, thumb pain, thenar muscle wasting and presence of nodes, deformity or enlargement best determined the presence of thumb ROA.Conclusion. The first CMC and thumb IP joints were frequently affected with ROA. Prevalence estimates of ROA would be underestimated if these were not scored. One-third of the individuals with thumb ROA did not have involvement of the first CMC joint. The presence of thumb ROA was strongly associated with a combination of older age, thumb pain and clinical features of OA.

A Comparison of Cervical Spine Mobilization Forces Applied by Experienced and Novice Physiotherapists

Clinical measurement, cross-sectional. To compare cervical mobilization forces applied by physiotherapists and students, and the factors associated with forces for each group. Cervical spine joint mobilization is a common manual technique for treating patients with mechanical neck pain. But little is known about the forces applied during this technique. Potential variability between therapists may result from clinical experience or may be due to factors present in individuals prior to clinical practice exposure. One hundred sixteen practicing physiotherapists and 120 physiotherapy students without clinical experience applied grades I through IV posteroanterior mobilization to the premarked C2 and C7 spinous and articular processes of 1 of 67 asymptomatic subjects. An instrumented table recorded applied forces (N), force amplitudes (N), and oscillation frequencies (Hz), and a custom device measured subjects' spinal stiffness (N/mm). Independent t tests were used to compare the forces applied by therapists and students, intraclass correlation coefficients were used to determine variability, and linear regression was used to establish factors associated with applied forces. Students' forces were generally lower (mean difference, 15.7 N for grades III and IV; P<.001) and applied with slower oscillation frequencies (0.12 Hz; P<.001) than therapists' forces. Similar factors were associated with applied forces for both groups: male gender and greater subject body weight were associated with higher applied forces, and greater C2 stiffness with lower forces. Having thumb pain was associated with lower applied forces for therapists but higher ones for students. Students apply lower forces than therapists. Similar factors appear to affect applied forces regardless of clinical experience.

Diagnostic Value of Clinical Grind Test for Carpometacarpal Osteoarthritis of the Thumb

Study Design Clinical Measurement. Introduction Thumb carpometacarpal (CMC) osteoarthritis is a frequent cause of thumb pain. Purpose of the Study To evaluate the interrater reliability and the criterion validity of the grind test for thumb CMC osteoarthritis. Methods Radiological evaluation was used as the gold standard. Seventy thumbs of 54 persons with various hand disorders were included in the study. The grind test was performed by two physical therapists, and radiographs were evaluated by a certified hand surgeon, all blinded to the participants' diagnosis and other test results. Interrater reliability was compared with a kappa statistic, and the sensitivity, specificity, likelihood ratios, and predictive values were calculated from a 232 table. Results A kappa value of 0.48 was calculated as the interrater reliability. The sensitivity of the grind test was 42% and 53%, depending on tester. The specificity of the grind test was 80% and 93%, depending on tester. The positive likelihood ratio was 2.65 and 6.00, and the negative likelihood ratio was 0.59 and 0.62. The positive predictive value was 91% and 96%, depending on tester. The negative predictive value was 68% and 70%, depending on tester. Conclusion The grind test has moderate reliability and accurately confirms the diagnosis of CMC osteoarthritis and identifies those who do not have CMC osteoarthritis. However, a negative grind test does not necessarily reflect negative radiographic evidence of thumb CMC osteoarthritis. Level of Evidence n/a

Osteoid Osteoma of the Thumb: A Case Report

Osteoid osteoma is a rare occurrence in the hand, and only a small percentage affects the thumb and distal phalanges. An 18-year-old right-hand-dominant man presented to our office with an approximately 1-year history of left thumb pain without any history of trauma. He had seen several doctors previously and undergone multiple diagnostic tests with no definitive diagnosis. Plain radiographs and computed tomography at our institution were consistent with the diagnosis of osteoid osteoma. The patient was treated with surgical excision of the lesion without bone grafting. The diagnosis of osteoid osteoma was confirmed by pathology. At 6months follow-up, the patient showed complete resolution of pain and full restoration of hand function. This case demonstrates that osteoid osteoma should not be forgotten as a differential diagnosis in patients with finger pain, especially in individuals who have not yet or just recently have reached skeletal maturity.

Cervical spine mobilisation forces applied by physiotherapy students

Objectives Postero-anterior (PA) mobilisation is commonly used in cervical spine treatment and included in physiotherapy curricula. The manual forces that students apply while learning cervical mobilisation are not known. Quantifying these forces informs the development of strategies for learning to apply cervical mobilisation effectively and safely. This study describes the mechanical properties of cervical PA mobilisation techniques applied by students, and investigates factors associated with force application. Participants Physiotherapy students ( n = 120) mobilised one of 32 asymptomatic subjects. Methods Students applied Grades I to IV central and unilateral PA mobilisation to C2 and C7 of one asymptomatic subject. Manual forces were measured in three directions using an instrumented treatment table. Spinal stiffness of mobilised subjects was measured at C2 and C7 using a device that applied a standard oscillating force while measuring this force and its concurrent displacement. Analysis of variance was used to determine differences between techniques and grades, intraclass correlation coefficients (ICC) were used to calculate the inter- and intrastudent repeatability of forces, and linear regression was used to determine the associations between applied forces and characteristics of students and mobilised subjects. Results Mobilisation forces increased from Grades I to IV (highest mean peak force, Grade IV C7 central PA technique: 63.7 N). Interstudent reliability was poor [ICC(2,1) = 0.23, 95% confidence interval (CI) 0.14 to 0.43], but intrastudent repeatability of forces was somewhat better (0.83, 95% CI 0.81 to 0.86). Higher applied force was associated with greater C7 stiffness, increased frequency of thumb pain, male gender of the student or mobilised subject, and a student being earlier in their learning process. Lower forces were associated with greater C2 stiffness. Conclusion This study describes the cervical mobilisation forces applied by students, and the characteristics of the student and mobilised subject associated with these forces. These results form a basis for the development of strategies to provide objective feedback to students learning to apply cervical mobilisation.

Digital Epipen® Injection: A Case of Conservative Management

A 46-year-old woman presented to the Emergency Department (ED) with left thumb pain after accidentally discharging her son's Epipen® (Dey, LP; Napa, CA) while cleaning out his belongings. She stated that the injury occurred approximately 40 min before her arrival. The Epipen® was the adult dose model and carried 0.3 mg of epinephrine. She did not know how much had been injected. She denied any other complaints except thumb pain. The past medical history was significant for hypertension, asthma, and gastritis.

Short-Term Outcomes of Trapeziometacarpal Artelon Implant Compared With Tendon Suspension Interposition Arthroplasty for Osteoarthritis: A Matched Cohort Study

To compare the short-term efficacy of the Artelon trapeziometacarpal (TMC) implant with that of total trapeziectomy and abductor pollicis longus (APL) tendon suspension interposition arthroplasty in TMC osteoarthritis. A single-center matched cohort study was designed. The Artelon cohort comprised 13 consecutive patients (10 women, 3 men; mean age, 54 years) operated on with Artelon implant arthroplasty. The APL cohort comprised 40 patients (33 women, 7 men; mean age, 58 years) randomly selected among 88 consecutive age-matched patients operated on with APL arthroplasty during the same period. The mean follow-up time was 13 (SD, 4) months for the Artelon group and 12 (SD, 3) months for the APL group. All patients completed the short-form Disabilities of the Arm, Shoulder, and Hand (QuickDASH) survey and a scale measuring thumb pain and related activity limitation, both scored 0 (best) to 100 (worst). Patient satisfaction was recorded. Physical examination was performed by a blinded therapist. The median QuickDASH score was 25 for the Artelon group and 20 for the APL group; the median pain scores were 38 and 28, respectively; the differences were not statistically significant. In the Artelon group, 8 patients were satisfied, compared with 32 in the APL group; the adjusted odds ratio of not being satisfied following Artelon implant compared to APL arthroplasty was 4. The median grip strength as a percentage of the contralateral hand was 82% in the Artelon group and 95% in the APL group; the median pinch strength was 61% and 86%, respectively. No statistically significant differences were found in thumb palmar or radial abduction. Two Artelon patients had revision to APL arthroplasty. The short-term outcomes of the Artelon TMC implant were not superior to those of tendon suspension interposition arthroplasty, a factor to be considered when comparing treatment cost effectiveness. Therapeutic III.