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Archives of Orthopaedic and Trauma Surgery

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01-07-2018 | Handsurgery

An anatomical study on the effectiveness of Arthrex Mini TightRope^® ligament reconstruction in an unstable trapeziometacarpal joint

Authors: T. R. Friebel, E. T. Walbeehm, G.-J. Kleinrensink, S. Ray, J. M. Zuidam

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2018

Abstract

Introduction

Laxity in the trapeziometacarpal (TMC) joint is a debilitating condition usually affecting a young population. It can be treated operatively with ligament reconstruction. The purpose of this study was to determine the effectiveness of the Arthrex Mini TightRope^® in reinforcing the stabilizing ligaments in an unstable TMC joint without decreasing the range of motion of the thumb. This method was compared with the “gold standard” published by Eaton and Littler in 1973.

Materials and methods

Six fresh frozen arms from five cadavers were included. TMC joint laxity was measured on stress view radiographs as the ratio of the radial subluxation (RS) of the first metacarpal in relation to the trapezium, by the first metacarpal articular width (AW) (as described by Wolf in 2009). Measurements of the pre- and post-operative range of motion (ROM) were performed and compared.

Results

Both the Arthrex Mini TightRope^® and the Eaton–Littler stabilization improved the stability of the TMC joint. The pre-operative laxity value (ratio RS/AW) of 0.27 was significantly (P = 0.02) improved by each of the surgical interventions (Eaton–Littler RS/AW = 0.05 and Tightrope RS/AW = 0.09). The pre- and post-operative range of motion was not significantly different by each of the surgical interventions. There were no significant differences between the two stabilizing methods regarding laxity or range of motion.

Conclusion

The Arthrex Mini TightRope^® provided a good stabilization method for the TMC joint in this anatomical model without compromising the range of motion.

Bettinger PC, Linscheid RL, Berger RA et al (1999) An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint. J Hand Surg 24:786–798CrossRef

Bettinger PC, Smutz WP, Linscheid RL et al (2000) Material properties of the trapezial and trapeziometacarpal ligaments. J Hand Surg 25:1085–1095CrossRef

Boughton OR, Mackenzie H (2012) Osteoarthritis of the trapeziometacarpal joint (TMJ): a review of the literature osteoarthritis—diagnosis, treatment and surgery. Prof. Qian Chen (Ed.) ISBN: 978-953-51-0168-0, InTech

Colman M, Mass DP, Draganich LF (2007) Effects of the deep anterior oblique and dorsoradial ligaments on trapeziometacarpal joint stability. J Hand Surg 32:310–317CrossRef

Cox CA, Zlotolow DA, Yao J (2010) Suture button suspensionplasty after arthroscopic hemitrapeziectomy for treatment of thumb carpometacarpal arthritis. Arthroscopy 26:1395–1403CrossRefPubMed

Eaton RG, Littler JW (1973) Ligament reconstruction for the painful thumb carpometacarpal joint. J Bone Joint Surg 55:1655–1666CrossRefPubMed

Gillis J, Calder K, Williams J (2011) Review of thumb carpometacarpal arthritis classification, treatment and outcomes. J Plast Surg 19:134–138CrossRef

Lane LB, Eaton RG (1987) Ligament reconstruction for the painful “prearthritic” thumb carpometacarpal joint. Clin Orthop Relat Res 220:52–57

Lane LB, Henley DH (2001) Ligament reconstruction of the painful, unstable, nonarthritic thumb carpometacarpal joint. J Hand Surg 26:686–691CrossRef

10.

Matullo KS, Ilyas A, Thoder JJ (2007) CMC arthroplasty of the thumb: a review. Hand 2:232–239CrossRefPubMedPubMedCentral

11.

Nyszkiewicz R, Neumann R (2001) [Experiences with Eaton-Littler reconstruction for therapy of ligament instability of the thumb saddle joint]. Handchir Mikrochir Plast Chir 33:424–430CrossRefPubMed

12.

Rayan G, Do V (2013) Dorsoradial capsulodesis for trapeziometacarpal joint instability. J Hand Surg 38:382–387CrossRef

13.

Song Y, Cox CA, Yao J (2013) Suture button suspension following trapeziectomy in a cadaver model. Hand 8:195–200CrossRefPubMed

14.

Tomaino MM (2011) Basal metacarpal osteotomy for osteoarthritis of the thumb. J Hand Surg 36:1076–1079CrossRef

15.

Van Brenk B, Richards RR, Mackay MB et al (1998) A biomechanical assessment of ligaments preventing dorsoradial subluxation of the trapeziometacarpal joint. J Hand Surg 23:607–611CrossRef

16.

Wolf JM, Oren TW, Ferguson B et al (2009) The carpometacarpal stress view radiograph in the evaluation of trapeziometacarpal joint laxity. J Hand Surg 34:1402–1406CrossRef

17.

Yao J, Song Y (2013) Suture-button suspensionplasty for thumb carpometacarpal arthritis: a minimum 2-year follow-up. J Hand Surg 38:1161–1165CrossRef

18.

Yao J, Zlotolow DA, Murdock R et al (2010) Suture button compared with K-wire fixation for maintenance of posttrapeziectomy space height in a cadaver model of lateral pinch. J Hand Surg 35:2061–2065CrossRef

Title: An anatomical study on the effectiveness of Arthrex Mini TightRope® ligament reconstruction in an unstable trapeziometacarpal joint
Authors: T. R. Friebel
E. T. Walbeehm
G.-J. Kleinrensink
S. Ray
J. M. Zuidam
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 7/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2942-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

An anatomical study on the effectiveness of Arthrex Mini TightRope^® ligament reconstruction in an unstable trapeziometacarpal joint

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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