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May 9, 2026Open Access

Trapeziectomy with Ligament Reconstruction and Tendon Interposition Versus Transosseous Suture Suspensionplasty for Thumb Trapeziometacarpal Osteoarthritis: A Retrospective Comparative Study

Key Points

This study aims to compare clinical and functional outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) versus transosseous suture suspensionplasty (SUSP) in TMC osteoarthritis.
Retrospective comparative study of 54 patients treated for TMC osteoarthritis between 2018 and 2022.
Comparison of clinical outcomes between LRTI (n=33) and SUSP (n=21) with evaluations at a minimum 2-year follow-up.
Outcomes measured included DASH score, VAS, key pinch strength, Kapandji score, and radial/palmar abduction.
At 2 years, no significant between-group differences in DASH (median 4 vs. 16.5; p = 0.190), VAS (2.0 ± 2.1 vs. 2.9 ± 2.3; p = 0.235), or key pinch strength (median 4 vs. 3 kg; p = 0.136).
Both groups improved significantly in DASH and VAS (p < 0.001) over time.
Key pinch strength increased progressively in the LRTI group (p < 0.001) but showed less consistent improvement in the SUSP group.

Abstract

Background: Several surgical techniques are available for the treatment of thumb trapeziometacarpal (TMC) osteoarthritis. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) is a widely accepted procedure, while suspensionplasty techniques have been introduced to improve first metacarpal stability after trapeziectomy. A simplified transosseous suture suspensionplasty (SUSP) has recently been introduced as an alternative to implant-based constructs, but comparative clinical data remain limited. This study aimed to compare the clinical and functional outcomes between LRTI and SUSP techniques in patients with TMC osteoarthritis. Methods: A retrospective comparative study was conducted on 54 consecutive patients treated surgically for TMC osteoarthritis between 2018 and 2022. Thirty-three patients underwent trapeziectomy with ligament reconstruction and tendon interposition (LRTI group), and 21 underwent trapeziectomy with transosseous suture suspensionplasty (SUSP group). At a minimum follow-up of 2 years, 44 patients were available for evaluation. Assessments were performed using DASH, 10 cm VAS, key pinch strength, Kapandji score, and radial/palmar abduction. Results: At 2 years, there were no significant between-group differences in DASH (median 4 vs. 16.5; p = 0.190), VAS (2.0 ± 2.1 vs. 2.9 ± 2.3; p = 0.235), key pinch (median 4 vs. 3 kg; p = 0.136), Kapandji score, or abduction. Both groups improved significantly over time in DASH and VAS (p < 0.001). Key pinch increased progressively in LRTI group (p < 0.001) but showed less consistent change in SUSP group. Conclusions: Both techniques provided comparable mid-term clinical and functional outcomes in patients with TMC osteoarthritis. No clear clinical advantage of suspensionplasty over tendon interposition was demonstrated. Transosseous suture suspensionplasty represents a valid alternative, while tendon interposition arthroplasty remains a reliable reference technique.

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