Trapeziectomy with Abductor Pollicis Longus Tendon Interposition Arthroplasty for First Carpometacarpal Joint Osteoarthritis: A Systematic Review

BACKGROUND: The prevalence of osteoarthritis (OA) of the first carpometacarpal (CMC) joint and subsequent thumb disability is rising. Abductor pollicis longus tendon interposition arthroplasty (APLTIA) has gained popularity as a procedure to alleviate pain and restore thumb function. METHODS: A systematic review was performed to assess the current reported outcomes of APLTIA. Inclusion criteria involved clinical studies with case-series as the minimal accepted level of evidence. Our primary outcome focussed on PROMs data, whilst secondary outcomes focussed on objective measures of function and complications. Papers investigating pathologies other than CMC OA or procedures other than APLTIA were excluded. RESULTS: Twelve studies were included (485 thumbs), all of which were observational in study design. APLTIA appears to be associated with a reduction in pain and functional improvement. APLTIA was not found to complicate further surgery. CONCLUSION: APLTIA may be associated with improvement in short-term pain relief and functional status. Further research is required to evaluate the benefits, duration of relief and long-term outcomes of APLTIA.