Arthroscopic Trapeziectomy and Suture Button Suspensionplasty: A Review of the Literature and Description of the "Three-Step Arthroscopic Trapeziectomy Technique".

In the last two decades, surgeons have rapidly developed arthroscopic techniques to treat basal joint osteoarthritis. Such techniques spare the joint capsule and ligaments, allow more accurate staging of cartilage degeneration to determine the most appropriate treatment, and decrease the risk of injury to the radial artery and superficial branch of the radial nerve. Arthroscopic resection arthroplasty of the trapezium can be performed as either partial or complete trapeziectomy. Many papers have described partial trapeziectomy but few have discussed complete trapeziectomy. Suture button implants avoid the drawbacks of temporary fixation using Kirschner wire, as well as the drawbacks of ligament reconstruction, which necessitates the sacrifice of a tendon and involves both wide exposure and scar tissue. This paper aimed to review the published data on the arthroscopic treatment of basal thumb osteoarthritis, with a special focus on stabilization using suture button suspensionplasty, and to present a technique that structures this procedure into three steps, allowing it to be performed in an easier, more organized, and faster way.

Component alignment in total wrist arthroplasty: success rate of surgeons in their first cases.

OBJECTIVE: The aim of this study was to assess the probability of achieving a satisfactory alignment in the performance of a first wrist arthroplasty. METHODS: The total wrist arthroplasties (ReMotion®) of 14 wrists of 7 corpses performed by 14 inexperienced surgeons were reviewed radiologically. Radial component alignment in the posteroanterior view (RCA-PA), radial component alignment in the lateral view (RCA-Lat), carpal component alignment in the posteroanterior view (CCA-PA) and carpal component alignment in lateral view (CCA-Lat) were measured. RESULTS: Mean RCA-PA angle was 9.6º, mean RCA-Lat angle 4.6º, mean CCA-PA angle 4.4º and mean CCA-Lat angle 10.1º. None of the arthroplasties had a satisfactory alignment. CONCLUSION: It is difficult for an inexperienced surgeon to achieve a correct component alignment in his/her first total wrist arthroplasty, especially in the carpal component. Therefore, we recommend that the position of the prosthesis is confirmed before securing it to the bone with the help of X-ray images.