There are various surgical procedures described for thumb carpometacarpal (CMC) arthritis. Various types of spacers and interposition arthroplasties performed show no significant difference in outcome of these patients. We propose the hypothesis that the tightrope is not better than traditional trapeziectomy.
To assess our hypothesis, we conducted a retrospective study with patients divided into two comparable groups. Group 1 included 28 patients with 30 trapeziectomies done with tightrope. Group 2 included 25 patients with 26 trapeziectomies done without any other procedure. All patients were scored using Quick DASH, Patient Rated Wrist Evaluation score and Nelson base of thumb arthritis scores both pre and post operatively.
Statistical analysis was performed. When comparing the pre- and post operative data using the paired t-test, there was a statistically significant improvement in scores, with all three scoring systems. This indicates that both operations provide a good outcome following surgery. However, there was no statistically significant difference between those that had trapeziectomy alone compared with those with trapeziectomy and tightrope.
The insertion of tightrope does not seem to provide any additional benefits in terms of clinical outcome.
Miss Tanaya Sarkhel is a consultant trauma & orthopaedic surgeon specialising in all aspects of upper limb surgery. Read more here: Miss Tanaya Sarkhel
Arvind Mohan, MBBS