Prospective Cohort Study Comparing Ligament Reconstruction with Tendon Interposition and Suture-Only Suspension Arthroplasty for the Treatment of Basal Joint Arthritis.

Basal joint arthritis is a common form of osteoarthritis. There is no consensus procedure for maintenance of trapezial height following trapeziectomy. Suture-only suspension arthroplasty (SSA) is a simple method for stabilizing the thumb metacarpal following trapeziectomy. This single-institution prospective cohort study compares trapeziectomy followed by either ligament reconstruction with tendon interposition (LRTI) or SSA for the treatment of basal joint arthritis. Patients underwent LRTI or SSA from 5/2018-12/2019. VAS pain scores, DASH functional scores, clinical thumb ROM, pinch and grip strength data, and patient-reported outcomes (PROs) were recorded and analyzed preoperatively, and at 6-weeks and 6-months postoperatively. Total number of study participants was 45 (LRTI 26, SSA 19). Mean (± standard error, SE) age was 62.4 (±1.5) years, with 71% female, and 51% operated were on the dominant side. VAS scores improved for LRTI and SSA (p<0.0001) over 6-months, with no differences between groups at any timepoint (p>0.3). DASH scores improved for LRTI and SSA over 6-months (p<0.0001), with no differences between groups at any timepoint (p>0.3). Following SSA, opposition improved (p=0.02), but not as well for LRTI (p=0.16). Grip and pinch strength decreased following LRTI and SSA at 6-weeks but recovered similarly for both groups over 6-months. PROs were generally no different between groups at all timepoints. LRTI and SSA are similar procedures following trapeziectomy relative to pain, function and strength recovery.