Osteotomy versus tendon arthroplasty in trapeziometacarpal arthrosis: 17 patients followed for 1 year

We evaluated 2 consecutive cohorts of patients with primary trapeziometacarpal arthrosis 1 year after either first metacarpal osteotomy or trapezial excision with abductor pollicis longus tendon arthroplasty. At follow-up, 4 of 7 patients treated with osteotomy had pain at rest and/or with light activities and were dissatisfied with the results of surgery, all 4 had advanced (stage III) preoperative trapeziometacarpal arthrosis. 1 of 10 patients (5 having stage III arthrosis) treated with abductor pollicis longus arthroplasty had pain with light activities, and no patient was dissatisfied. Our findings indicate that first metacarpal osteotomy as a surgical option in trapeziometacarpal arthrosis should be limited to patients with early disease.