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JDRS · Open access journal
Joint Diseases and
Related Surgery
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Original Article · Open access

Thumb carpometacarpal osteoarthritis: Arthrodesis versus trapeziectomy with ligament reconstruction and tendon interposition

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Cengiz Aldemir

Department of Orthopedics and Traumatology, Health Sciences University Antalya Training and Research Hospital, Antalya, Türkiye

ORCID: 0000-0003-3170-592X

Tahir Ozturk

Department of Orthopedics and Traumatology, Memorial Bahcelievler Hospital, İstanbul, Türkiye

ORCID: 0000-0003-0847-2128

Hakan Ertem

Department of Orthopedics and Traumatology, İnönü University Faculty of Medicine, Malatya, Türkiye

ORCID: 0000-0002-1724-4138

Yener Aydın

Department of Orthopedics and Traumatology, Karadeniz Technical University School of Medicine, Trabzon, Türkiye

ORCID: 0000-0003-3268-3419

Eyup Cagatay Zengin

Department of Orthopedics and Traumatology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Türkiye

ORCID: 0000-0002-9843-790X

Ahmet Piskin

Department of Orthopedics and Traumatology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye

ORCID: 0000-0001-7473-8364

Firat Erpala

Department of Orthopedics and Traumatology, Çeşme Alper Çizgenakat State Hospital, İzmir, Türkiye

ORCID: 0000-0003-3627-7055

Muhittin Sener

Orthopedics and Traumatology, Private Practice, İzmir, Türkiye

ORCID: 0000-0002-4544-3644

Abstract

Objectives: In this study, we aimed to compare the clinical and radiological outcomes of patients undergoing arthrodesis and trapeziectomy with ligament reconstruction and tendon interposition (T + LRTI) for thumb carpometacarpal (CMC) osteoarthritis and to investigate whether patient-specific decision-making could offer advantages over LRTI or arthrodesis as a surgical approach.

Patients and methods: Between August 2014 and January 2025, a total of 40 patients who underwent surgical treatment for thumb CMC osteoarthritis were retrospectively analyzed. The patients were divided into two groups as the T + LRTI group (n = 22) and arthrodesis group (n = 18). Clinical outcomes were assessed using the Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), grip strength (kg), and pinch strength (kg) measurements.

Results: Of the patients, 7 were male and 33 were female with a mean age of 62.9 ± 6.5 years in T + LRTI group, 60.1 ± 7.4 years in arthrodesis group (range, 40 to 75 years). Both groups demonstrated significant improvement in VAS and QuickDASH scores postoperatively (p < 0.001). The mean postoperative VAS scores were 2.7 ± 2.0 in the T + LRTI group and 1.9 ± 0.9 in the arthrodesis group (p = 0.267), while QuickDASH scores were 26.4 ± 17.3 and 19.1 ± 3.2, respectively (p = 0.085). No significant differences were observed in grip strength (p = 0.358), palmar pinch (p = 0.104) and key pinch strength (p = 0.097) between the groups. The overall complication rate was 12.5% in both groups, indicating no statistically significant difference (p = 0.642).

Conclusion: Our study results suggest that both T + LRTI and arthrodesis provide effective and comparable pain relief and functional outcomes in the surgical management of thumb CMC osteoarthritis and can be considered reliable surgical options.

Declarations

Author Contributions

C.A., M.S.: Conception and design, drafting of the article; C.A., M.S., T.O., H.E., Y.A., E.C.Z., A.P., F.E.: Collection and assembly of data; C.A., F.E., M.S.: Analysis and interpretation of the data, statistical expertise; C.A., M.S., F.E.: Critical revision of the article for important intellectual content. All authors read and approved the final manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

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