Thumb carpometacarpal osteoarthritis: Arthrodesis versus trapeziectomy with ligament reconstruction and tendon interposition
Cengiz Aldemir1
, Tahir Ozturk2, Hakan Ertem3, Yener Aydın4, Eyup Cagatay Zengin5, Ahmet Piskin6, Firat Erpala7, Muhittin Sener8
1Department of Orthopedics and Traumatology, Health Sciences University Antalya Training and Research Hospital, Antalya, Türkiye
2Department of Orthopedics and Traumatology, Memorial Bahcelievler Hospital, İstanbul, Türkiye
3Department of Orthopedics and Traumatology, İnönü University Faculty of Medicine, Malatya, Türkiye
4Department of Orthopedics and Traumatology, Karadeniz Technical University School of Medicine, Trabzon, Türkiye
5Department of Orthopedics and Traumatology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Türkiye
6Department of Orthopedics and Traumatology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
7Department of Orthopedics and Traumatology, Çeşme Alper Çizgenakat State Hospital, İzmir, Türkiye
8Orthopedics and Traumatology, Private Practice, İzmir, Türkiye
Keywords: Arthrodesis, carpometacarpal, grip, ligament reconstruction and tendon interposition, osteoarthritis, trapeziectomy.
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.
Citation: Aldemir C, Ozturk T, Ertem H, Aydın Y, Zengin EC, Piskin A, et al. Thumb carpometacarpal osteoarthritis: Arthrodesis versus trapeziectomy with ligament reconstruction and tendon interposition. Jt Dis Relat Surg 2026;37(3):777-784. doi: 10.52312/ jdrs.2026.2927.
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.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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