Suture-button Suspensionplasty versus Tendon Interposition and Ligament Reconstruction in Rhizarthrosis Surgical Treatment: a Systematic Review

Abstract

Purpose: To systematically review and compare the functional outcomes of Suture-button Suspensionplasty to those of Ligament Reconstruction and Tendon interposition, in the treatment of patients with trapeziometacarpal osteoarthritis. Methods: We performed a systematic literature search on PubMed, Scopus, and Web of Science, according to the PRISMA guidelines. Data on study design and characteristics, patient demographics and preoperative and postoperative grip, tip pinch and key pinch strength was collected, as well as trapezial space ratio, range of motion, patient reported outcomes via DASH and VAS scores and complication rates. Results: Our search strategy generated 875 records, of which 8 were included for analysis. Within the embraced studies, 192 thumbs were treated with LRTI and 61 with SBS. Patient demographics were similar between groups. Similar improvement in grip and tip pinch strength was observed in both techniques, alongside DASH and VAS scores, while maintaining ROM. Key pinch strength was consistently improved with SBS but not with LRTI. All studies showed a decrease in trapezial space ratio within the follow-up period. Complication rate was 24.5% in the LRTI group and 19.4% in SBS. Conclusion: Both SBS and LRTI are effective in improving grip strength, tip pinch strength, and patient reported outcomes, while maintaining range of motion. Although SBS showed more consistent functional improvement, particularly in key pinch measurements, the predominant lower level of evidence of studies regarding SBS compromises external validity of our findings. Thus, high quality large prospective controlled studies are needed.