Comparative Outcomes of Oblique vs. Transverse Bone Tunnels in Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis.

Abstract

Abstract: This retrospective non-randomized study aimed to compare the clinical and radiological outcomes of oblique versus transverse tunnels in ligament reconstruction and tendon interposition arthroplasty. This study included 15 patients with oblique tunnels (Group 1) and 13 patients with transverse tunnels (Group 2), all of whom had been diagnosed with Eaton stage 3 or 4 carpometacarpal arthritis and had undergone trapeziectomy with the ligament reconstruction and tendon interposition surgery. The visual analogue scale was used to assess pain levels, while the Quick Disabilities of the Arm, Shoulder and Hand questionnaire was used to evaluate functional limitations in activities of daily living. Preoperative and postoperative radiological findings as well as the thumb range of motion, grip strength, key pinch strength, and tip pinch strength were measured. Demographic data and complications were also documented. The change in Quick Disabilities of the Arm, Shoulder and Hand scores in Group 1 was significantly greater than that in Group 2. No significant differences were found between the two groups in visual analogue scale changes, range of motions, pinch strength assessments, or any radiological outcomes. In the treatment of thumb carpometacarpal joint arthritis with the ligament reconstruction and tendon interposition surgery, the oblique tunnel orientation in the ligament reconstruction and tendon interposition surgery for thumb carpometacarpal arthritis improves the Quick Disabilities of the Arm, Shoulder and Hand score, but does not significantly affect pain, complications, or radiological outcomes. These findings provide important insights for the selection of tunnel orientation in ligament reconstruction and tendon interposition applications.