Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis.
BACKGROUND
Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty.


METHODS
The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs.


RESULTS
The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously.


CONCLUSIONS
The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results.
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
Hyun-Joo
HJ
Lee
Department of Orthopaedic Surgery, Daegu Park Hospital, Daegu, Korea.
Poong-Taek
PT
Kim
Korea Institute of Science and Technology, Seoul, Korea. ; University of Science and Technology, Daejeon, Korea.
Maria Florencia
MF
Deslivia
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
In-Ho
IH
Jeon
Department of Orthopaedic Surgery, Kyemyung University Dongsan Medical Center, Daegu, Korea.
Suk-Joong
SJ
Lee
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
Sang-Jin
SJ
Nam
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052737:Carpometacarpal Joints / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery*; D013933:Thumb / Q000601:surgery*
Carpometacarpal joint; Osteoarthritis; Suspension ligamentoplasty; Tendon; Thumb