Thumb basal joint arthritis is the most common arthritis in the hand. When cortisone injections, bracing, and other conservative treatments no longer provide adequate pain relief, a surgical procedure is a great option.
There are many versions of the basal joint arthroplasty that work well, and all of these procedures typically include removal of the trapezium bone to provide pain relief.
The biggest variable that hand surgeons often debate is how best to “suspend” the 1st metacarpal once the trapezium base has been removed. Over the course of my career, I’ve used various techniques, including the classic ligament reconstruction tendon interposition (LRTI), the simple trapeziectomy w/ pinning, the mini tightrope procedure, and even the internal brace technique. Each one of these procedures has always provided pain relief and improved function for my patients, but each has its own drawbacks and pitfalls.
Now, over the past 4 years, thanks to my very smart friend and colleague Dr @AJJulka , I’ve learned this very reliable, quick, and satisfying suture suspensionplasty of the basal joint. Here I demonstrate my adaptation of this technique for use with the Arthrex FiberTak DX suture anchor.
The benefits of this procedure:
1) Strong and reliable “time zero” suspension of the first metacarpal
2) Can remove splint for early thumb motion at 1 week
3) Minimal to no loss of thumb range of motion in any direction or plane after tight tensioning of the sutures
Please take a peek at my video and let me know your thoughts in the comment section!!
#orthopedicsurgeon #upperextremity #handsurgeon #handtherapy #thumbarthritis #orthopedicsurgeon
