Ligament Reconstruction in Thumb Basal Joint Arthroplasty

Abstract

Osteoarthritis of the thumb trapeziometacarpal (TM) joint due to degeneration of the anterior oblique "beak" ligament results in pathologic laxity, abnormal translation of the metacarpal on the trapezium, and generation of excessive shear forces between the joint surfaces during grip and pinch activity. This article describes our rationale for performing ligament reconstruction and trapezium excision (LRTI arthroplasty) in the treatment of thumb basal joint arthritis. Surgical procedure steps are detailed, and normal TM joint anatomy and biomechanics, as well as pathoanatomy, are also presented to provide a better understanding of this region of the hand.

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