Trapeziectomy With Suture Suspensionplasty for Thumb Carpometacarpal Arthritis: A Novel, Economical Alternative to Suture Button Suspensionplasty

Arthritis of the thumb carpometacarpal (CMC) joint is common, with an estimated radiographic prevalence of 10.9% and 13.7% of 60-year-old males and females, respectively. Approximately 15% of symptomatic patients will go on to surgery after failing conservative management. Multiple procedures have proven effective for the treatment of thumb CMC arthritis, each with different risks and benefits regarding morbidity, recovery time, and cost. While trapeziectomy with ligament reconstruction and tendon interposition is the most common surgical technique in the United States for thumb CMC arthritis, the optimal operative management remains inconclusive. Trapeziectomy with suture button suspensionplasty (Arthrex, Mini TightRope) has gained popularity in recent years as a new method for treating thumb CMC arthritis. By obviating the need for Kirschner wire fixation or tendon autograft, morbidity is spared, and earlier initiation of occupational therapy and motion is achievable. However, suture button techniques require fluoroscopy and expensive implants, which may require removal due to prominence. We present a novel, more economical alternative to the commercially available suture button suspensionplasty, which can be performed without fluoroscopy and with readily available suture (#2 Orthocord). This procedure has been performed as a primary reconstruction in 80 hands since 2016 with a 2.5% (2/80) reoperation rate and high patient satisfaction.