Thumbs-Up Results after Thumb Ligament Reconstruction SurgeryThe trapeziometacarpal (TM) joint is located at the base of the thumb. When it is loose and painful, people struggle to do everyday activities. Thus, the health of this important joint can determine if a person has a thumbs-up or thumbs-down day.
When the TM joint is mildly loose and hasn't developed arthritis, doctors can do surgery to tighten and protect the thumb joint. Sections of two nearby tendons are weaved in and around the sore joint. The idea is that the tendons will take over the function of the injured and loosened thumb ligaments.
How well does the procedure work? The authors followed up on 35 patients an average of five years after surgery. Most were women (29), and the average age was 33. Ninety-seven percent had either an "excellent" or "good" result. Only one patient required another surgery because of ongoing pain. All patients showed stable thumb joints after surgery. And all but two resumed their jobs and sports.
This form of surgery is best used when the TM joint is mildly loose--but not arthritic. When arthritis is present, the authors recommend the use of other surgical procedures. When these guidelines are used, this surgery also appears to keep the joint from eventually becoming arthritic. X-rays taken years after the surgery in this study showed no signs of thumb arthritis.
Along with the exceptional benefits shown in this study, the thumbs-up results support the notion that tightening up this joint before arthritis occurs may prevent future problems with thumb arthritis.
Lewis B. Lane, MD, and Deborah H. Henley, MD. Ligament Reconstruction of the Painful, Unstable, Nonarthritic Thumb Carpometacarpal Joint. In The Journal of Hand Surgery. July 2001. Vol. 26A. No. 4. Pp. 686-691.
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