Arthroscopic Complete Trapeziectomy and Suture Button Suspensionplasty for the Treatment of Osteoarthritis of the Carpometacarpal Joint of the Thumb

Description

In this instructional presentation, Alexei Buruiann discusses the procedure of arthroscopic complete trapeziectomy combined with suture button suspensionplasty, specifically targeting the treatment of osteoarthritis affecting the carpometacarpal joint of the thumb. The presentation outlines the significance of this condition, emphasizing the thumb's carpometacarpal joint as a prevalent site for osteoarthritis in the upper limb. It reviews conservative treatment strategies like activity modification and medication, and contrasts these with surgical options including trapeziectomy, which often requires stabilization techniques for optimal long-term outcomes.



The advantages of using a suture button for stabilization are noted, particularly for allowing early mobilization without sacrificing tendon function. Buruiann explains the rationale behind choosing arthroscopic over open techniques, which include preserving joint capsule and ligaments, the ability to inspect cartilage, and minimizing the risk of nerve injury. The presentation further highlights specific risks associated with arthroscopic trapeziectomy, such as potential nerve damage due to traction.



Buruiann details the case study of a woman in her 60s suffering from grade 4 thumb arthritis, illustrating the surgical method performed using dry arthroscopy through the necessary portals, including a comprehensive three-step approach for trapeziectomy as described by Corella. Key surgical steps, the devices used, and the importance of managing surgical traction to prevent complications are covered. The presentation concludes by detailing the postoperative progress of the patient, showcasing significant improvement in thumb function and pain-free movement after surgery, and referencing a study affirming the efficacy of the technique with low complication rates. The authors declare no conflicts of interest, concluding with gratitude for the audience's attention.

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