Suture suspension sling arthroplasty in thumb carpometacarpal joint arthritis: A case series

INTRODUCTION AND IMPORTANCE: Thumb carpometacarpal (CMC) joint arthritis is the most common condition in older adults and an upper-extremity surgical reconstruction site. Multiple treatments for CMC arthritis have been developed. Among them, suspension sling arthroplasty provides great results without requiring a tendon graft or advanced implants. However, it is rarely used in Indonesia. CASE PRESENTATION: The modified suture suspension sling arthroplasty technique developed by Arnold Peter C Weiss was performed on three patients with CMC joint arthritis. In this procedure, after trapeziectomy, a nonabsorbable suture is performed to create a hammock between the abductor pollicis longus and flexor carpi radialis tendon to rest the thumb base metacarpal. The rehabilitation protocol was then continued, and the postoperative clinical condition was observed. Three weeks postoperatively, none of the three patients complained of pain. At 3 months postoperatively, there were no signs of infection, and all patients continued the rehabilitation protocol. At 6 months postoperatively, thumb range of motion was excellent, with no sign of infection and an increased DASH score of <5. CLINICAL DISCUSSION: Multiple treatments for CMC joint arthritis have been described in the literature but the indications and which treatment provides the best results were unclear. Among the various suspension sling methods, trapeziectomy is important for treating CMC joint arthritis. CONCLUSION: Suture suspension arthroplasty for treating thumb CMC joint arthritis achieved excellent clinical results and has several advantages, including shorter surgical time, no additional incision, reduced cost, no tendon harvesting, and implant fixation.