Thumb carpometacarpal osteoarthritis is a common cause of pain, weakness and functional disability. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) is considered a standard surgical procedure, whereas Mini TightRope suspensionplasty has been introduced to facilitate earlier mobilization while maintaining first metacarpal stability. This prospective randomized single-center clinical trial compares Mini TightRope suspensionplasty with LRTI in patients with symptomatic Eaton-Littler stage II-IV thumb carpometacarpal osteoarthritis. Fifty patients were randomized in a 1:1 ratio to undergo either Mini TightRope suspensionplasty or LRTI. Clinical and radiographic outcomes were evaluated preoperatively and at 3 months, 6 months, 1 year and 2 years postoperatively. The primary outcome was the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) score at 2 years. Secondary outcomes included pain, thumb opposition, grip strength, pinch strength, operative time, radiographic preservation of metacarpal height and complications.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Complete trapeziectomy followed by suspension of the first metacarpal using the Arthrex Mini TightRope suture-button system
Complete trapeziectomy with ligament reconstruction using the flexor carpi radialis tendon and tendon interposition.
University Hospital of Larissa, Thessaly, Greece
Larissa, Thessaly, Greece
quick DASH score
Quick Disabilities of the Arm, Shoulder and Hand score measured preoperatively and during follow-up, with the primary endpoint at two years.
Time frame: 2 years
VAS score
Visual Analog Scale pain score
Time frame: 2 years
Kapandji score
Kapandji thumb opposition score
Time frame: 2 years
Grip strength
Grip strength using a dynamometer
Time frame: 2 years
Trapeziometacarpal Index
the ratio between the distance from the base of the first metacarpal to the distal surface of the scaphoid and the total length of the first metacarpal
Time frame: 2 years
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