Extensor carpi radialis longus tendon arthroplasty in the treatment of primary trapeziometacarpal arthrosis.

A prospective study was conducted to evaluate patient outcomes following trapezial excision and extensor carpi radialis longus tendon arthroplasty in primary trapeziometacarpal arthrosis. Seventeen patients were evaluated both preoperatively and postoperatively at both 12 months and at final follow-up examination at a mean of 39 months (range, 20-56 months). Surgery resulted in complete or significant pain relief and satisfaction with outcome for 16 patients as evaluated at final follow-up examination. Patients with a longer history of thumb pain and more advanced preoperative radiographic changes were more likely to have residual pain after surgery. The mean preoperative activities of daily living (ADL) scores improved significantly. The mean pulp and key pinch strength were 93% and 100%, respectively, of the preoperative values but were significantly lower than the mean pinch strengths recorded in an age-matched control population. Substantial proximal migration of the first metacarpal during maximal pinch was noted in 4 patients who still had some degree of thumb pain with light work. Scaphotrapezoid arthrosis had no correlation to postoperative residual pain.