Trapeziectomy and Mini TightRope Suspensionplasty for First Carpometacarpal Joint Arthritis

Introduction: First carpometacarpal (CMC) joint arthritis is a common debilitating condition affecting thumb function. Surgical management often involves trapeziectomy to alleviate pain and restore functionality. The suspensionplasty techniques maintain the trapezial height after trapeziectomy. The older techniques used the help of ligamentoplasty by taking the flexor carpi radialis or the abductor pollicis longus. A new technique of suspensionplasty where the first metacarpal is suspended to the second by means of a strong suture material (fiberwire) and tied with help of a suture button (Mini TightRope; Arthrex, Naples, FL, USA). This technique is less invasive than the previous ligamentoplasties, because there is no need to harvest another nearby tendon. The addition of Mini TightRope suspensioplasty aims to stabilize the joint, potentially improving outcomes.

Methods: A retrospective analysis was conducted on 20 patients undergoing trapeziectomy and Mini TightRope suspensioplasty between January 2022 and December 2023. Preoperative and postoperative assessments included pain scores, grip strength measurements, range of movement evaluations, and patient-reported outcomes using standardized questionnaires.

Results: Significant improvements were observed postoperatively in pain relief, with Visual Analog Scale scores decreasing from 7.8 preoperatively to 1.2 at six months follow-up. Grip strength increased by an average of 35%, and 85% of patients achieved near-normal range of movement. Patient-reported outcomes indicated high satisfaction rates, with enhanced ability to perform daily activities.

Conclusion: Trapeziectomy combined with Mini TightRope suspensionplasty demonstrates favorable outcomes in managing first CMC joint arthritis. This approach effectively reduces pain, improves grip strength, and enhances functional capabilities, underscoring its role as a promising surgical option for patients seeking relief from thumb arthritis.