Outcomes and Complications of Suture-Button versus All-Suture Suspensionplasty in Thumb Carpometacarpal Arthritis: A Retrospective Comparative Study.

Abstract

Background: Our objective is to compare clinical, radiographic and complication-related outcomes between two non-autologous implants - Mini TightRope^® and Microlink™ - used in suspensionplasty following open trapeziectomy for thumb carpometacarpal joint arthritis. Methods: We retrospectively analysed 77 patients (41 Mini TightRope^®, 36 Microlink™) treated between 2017 and 2021 with a minimum follow-up of 36 months. All surgeries were performed by the same experienced hand surgeon using a standardised open technique. Pre- and postoperative assessments included Quick Disabilities of the Arm, Shoulder and Hand (QDASH), visual analogue scale (VAS; rest and effort), Kapandji score, grip and pinch strength, thumb range of motion (ROM), patient satisfaction and radiographic evaluation for metacarpal subsidence. Complications and reoperations were recorded and compared. Results: Both groups demonstrated significant clinical improvement, with no statistically significant differences in functional scores, ROM, strength, pain or satisfaction. Implant-related complications differed notably: four Mini TightRope^® patients (9.8%) required implant removal due to discomfort, and one experienced a transient sensory neurapraxia, yielding a total complication rate of 12.2%. In the Microlink™ group, only one patient (2.8%) experienced a similar neurapraxia, and no implant removals or reoperations were needed. No subsidence was observed in either group. Conclusions: Both implants were clinically effective, but the Microlink™ device was associated with a lower complication rate and no removals. These findings suggest that all-suture implants may offer improved soft-tissue compatibility. This is the first clinical report on Microlink™, and its mid-term results appear comparable to those of the more established Mini TightRope^®. Further prospective studies are warranted to assess long-term outcomes. Level of Evidence: Level III (Therapeutic).