Biomechanical Strength of Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Reconstruction With Button Autograft and Suture Suspension (BASS) Technique in a Cadaveric Osteolysis Model

IF 2.4 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2026-10-01 Epub Date: 2026-05-26 DOI:10.1016/j.jhsa.2026.04.009

Riley Kahan MS, Dylan R. Rakowski MD, Evan H. Richman MD, Adam Peszek MD, Todd Baldini MS, Matthew Belton MD, Alexander Lauder MD

{"title":"Biomechanical Strength of Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Reconstruction With Button Autograft and Suture Suspension (BASS) Technique in a Cadaveric Osteolysis Model","authors":"Riley Kahan MS, Dylan R. Rakowski MD, Evan H. Richman MD, Adam Peszek MD, Todd Baldini MS, Matthew Belton MD, Alexander Lauder MD","doi":"10.1016/j.jhsa.2026.04.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Polyetheretherketone anchors used for thumb metacarpophalangeal (MP) joint ulnar collateral ligament (UCL) repair/reconstruction may be associated with osteolysis and subsequent failure, which presents challenges to revision reconstruction. This study evaluated the biomechanical integrity of thumb UCL reconstruction in a cadaveric osteolysis model.</div></div><div><h3>Methods</h3><div>Twelve thumb MP joints at 0° of flexion were loaded to failure by applying valgus force to produce UCL injury. Both clinical failure, defined as the force necessary to elicit 30° of angular displacement or 11.5 mm of vertical displacement across the MP joint, and structural failure, the maximum force applied to produce a decrease in resistance, were recorded. One specimen fractured during testing and was excluded. In the remaining 11 specimens, osseous tunnels (5 mm diameter × 10 mm depth) were drilled at the ligament proximal origin and distal insertion to simulate osteolysis. The UCL was reconstructed with button suspension of palmaris longus tendon autograft and nonabsorbable suture (button autograft and suture suspension, BASS), and the MP joints were again loaded to clinical and structural failure recording force, anatomic location, and mode of failure. The experimental group was compared to intrinsic native ligament controls using paired <em>t</em> tests.</div></div><div><h3>Results</h3><div>Eleven specimens had complete data for comparison of the reconstruction to native ligament. Native UCLs failed clinically at 112 ± 38 N and structurally at 169 ± 75 N, whereas BASS UCL reconstruction in the osteolysis model failed at significantly less force: clinically 27 ± 12 N and structurally at 68 ± 37N. All UCL reconstructions failed by fracture: 8/11 at the proximal phalanx and 3/11 at the metacarpal.</div></div><div><h3>Conclusions</h3><div>BASS UCL reconstruction in the setting of osteolysis produced a weaker construct than the native UCL but provided biomechanical strength similar to established UCL reconstruction methods.</div></div><div><h3>Clinical relevance</h3><div>This study detailed the biomechanical strength of this technique and informs postoperative rehabilitation considerations when osteolysis is present.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"51 10","pages":"Pages 1077.e1-1077.e11"},"PeriodicalIF":2.4000,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand Surgery-American Volume","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S036350232600314X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/5/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Polyetheretherketone anchors used for thumb metacarpophalangeal (MP) joint ulnar collateral ligament (UCL) repair/reconstruction may be associated with osteolysis and subsequent failure, which presents challenges to revision reconstruction. This study evaluated the biomechanical integrity of thumb UCL reconstruction in a cadaveric osteolysis model.

Methods

Twelve thumb MP joints at 0° of flexion were loaded to failure by applying valgus force to produce UCL injury. Both clinical failure, defined as the force necessary to elicit 30° of angular displacement or 11.5 mm of vertical displacement across the MP joint, and structural failure, the maximum force applied to produce a decrease in resistance, were recorded. One specimen fractured during testing and was excluded. In the remaining 11 specimens, osseous tunnels (5 mm diameter × 10 mm depth) were drilled at the ligament proximal origin and distal insertion to simulate osteolysis. The UCL was reconstructed with button suspension of palmaris longus tendon autograft and nonabsorbable suture (button autograft and suture suspension, BASS), and the MP joints were again loaded to clinical and structural failure recording force, anatomic location, and mode of failure. The experimental group was compared to intrinsic native ligament controls using paired t tests.

Results

Eleven specimens had complete data for comparison of the reconstruction to native ligament. Native UCLs failed clinically at 112 ± 38 N and structurally at 169 ± 75 N, whereas BASS UCL reconstruction in the osteolysis model failed at significantly less force: clinically 27 ± 12 N and structurally at 68 ± 37N. All UCL reconstructions failed by fracture: 8/11 at the proximal phalanx and 3/11 at the metacarpal.

Conclusions

BASS UCL reconstruction in the setting of osteolysis produced a weaker construct than the native UCL but provided biomechanical strength similar to established UCL reconstruction methods.

Clinical relevance

This study detailed the biomechanical strength of this technique and informs postoperative rehabilitation considerations when osteolysis is present.

查看原文本刊更多论文

骨溶解模型拇指掌指关节尺侧副韧带重建的生物力学强度研究。

目的：聚醚醚酮锚钉用于拇指掌指骨（MP）关节尺侧副韧带（UCL）的修复/重建可能与骨溶解和随后的失败有关，这对翻修重建提出了挑战。本研究在尸体骨溶解模型中评估拇指UCL重建的生物力学完整性。方法：用外翻力对12个屈曲0°的拇指MP关节施加载荷，使其失效，造成UCL损伤。临床失败（定义为在MP关节上引起30°角位移或11.5 mm垂直位移所需的力）和结构失败（施加的最大力导致阻力减少）都被记录下来。一个试样在试验中断裂，被排除在外。在其余11个标本中，在韧带近端起始点和远端止点处钻孔骨隧道（直径5 mm × 10 mm深）以模拟骨溶解。采用自体掌长肌腱扣状悬吊和不可吸收缝线（扣状悬吊和缝合悬吊，BASS）重建UCL，并再次加载中端关节至临床和结构失效记录受力、解剖位置和失效模式。使用配对t检验将实验组与固有韧带对照组进行比较。结果：11例标本资料完整，可与原位韧带重建进行比较。原生UCL在112±38 N时临床失败，在169±75 N时结构失败，而骨溶解模型中BASS UCL重建在明显较小的力下（临床27±12 N， 68±37N）结构失败。所有UCL重建均因骨折失败：近端指骨为8/11，掌骨为3/11。结论：在骨溶解的情况下，BASS UCL重建产生的结构比天然UCL弱，但提供的生物力学强度与已建立的UCL重建方法相似。临床意义：本研究详细介绍了该技术的生物力学强度，并为出现骨溶解时的术后康复提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.