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Trapeziectomy

Overview

Trapeziectomy is a primary surgical option for trapeziometacarpal osteoarthritis, with outcomes comparable to total joint arthroplasty regarding patient-reported function at one year [19]. While total joint arthroplasty demonstrates significant advantages over trapeziectomy in strength and range of motion at one year [19], it offers no superiority in total Michigan Hand Outcomes Questionnaire scores [19]. Secondary trapeziectomy following failed trapeziometacarpal implant revision yields results comparable to primary procedures [1, 2].

Surgical technique variations show mixed efficacy. Excision, tendon interposition, and ligament reconstruction with tendon interposition variations produce similar outcomes at five years [3], though simple trapeziectomy may offer an advantage over ligament reconstruction and tendon interposition pending further study [8]. Partial trapeziectomy provides no advantage over total trapeziectomy at one year [4]. Suspended techniques show good patient-reported outcomes in primary surgery but poor outcomes after secondary surgery [6]. The value of adding ligament reconstruction and temporary Kirschner wire stabilization remains unproven [13], and complete trapezoid excision is not recommended [7].

Implant augmentation requires careful selection. Trapeziectomy combined with a Swanson implant yields better short-term results if no complications occur [10]. There are no significant differences in outcomes between partial and complete trapezoid excision [12].

Anatomy & Pathophysiology

Osseous and Kinematic Outcomes

Trapeziectomy induces proximal migration of the first metacarpal, a phenomenon that does not appear to influence functional outcomes [23, 24]. While suture suspensionplasty mitigates this migration while maintaining normal motion, implant arthroplasty demonstrates superior reduction in axial and radial displacement compared with ligament reconstruction with tendon interposition (LRTI) [23, 29]. Implant arthroplasty also maintains the trapezial space better than LRTI [29]. Regarding device placement, positioning in either a proximal or distal location on the second metacarpal yields similar safety and range of motion results [21], and the position of the bone anchor in the thumb metacarpal base does not affect range of motion [30]. Furthermore, postoperative position of the thumb metacarpal base does not affect clinical or subjective outcomes after trapeziectomy with LRTI [37].

Stability and Joint Preservation

Performing a trapeziectomy followed by up to 4 mm of proximal trapezoid resection has a negligible effect on carpal stability, specifically regarding the lunocapitate and scapholunate joints [26]. Both TightRope constructs provided improved axial stability after trapeziectomy without excessively limiting any specific thumb motion [41]. In a cadaveric model, there was no statistical difference between the kinematics of LRTI and suspensionplasty [31]. LRTI and suture-only suspension arthroplasty (SSA) exhibit equivalent thumb metacarpal subsidence over a postoperative period exceeding 6 months [34]. Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy [1].

Functional Outcomes and Long-Term Gains

Suture suspension trapeziectomy arthroplasty provides an increase in grip strength and key pinch with early return of range of motion [33]. However, the decrease in key pinch force was larger than the relatively small increase in thumb CMC force following trapeziectomy and flexor carpi radialis suspensionplasty [25]. There is no early functional superiority of suture-button suspensionplasty over LRTI for thumb carpometacarpal arthritis [38]. A modified procedure involving partial trapeziectomy and pyrocarbon interpositional arthroplasty improves functional results by increasing active and passive range of movement at the TMCJ while providing joint stability and pain relief comparable to standard techniques [32]. This modified approach also preserves thumb length and key pinch strength [32]. Long-term follow-up of abductor pollicis longus tendon interposition surgery shows some reduction in thumb abduction from 3.5 to 13 years, yet other gains are retained and in some instances slightly improved during this interval [40]. Suture button suspensionplasty can fail, requiring salvage using pyrocarbon arthroplasty [36].

Classification

Primary vs. Secondary Procedures: Secondary trapeziectomy following the revision of trapeziometacarpal implants yields results comparable to primary trapeziectomy [1], and outcomes after failed joint replacement arthroplasty generally do not differ from primary procedures [2]. However, while trapeziectomy with alternative suspension techniques demonstrates good patient-reported outcome measures (PROMs) in primary surgery, these measures are poor following secondary surgery [6].

Excision Extent and Technique: Simple excision of the trapezium remains an acceptable treatment for osteoarthritis of the trapeziometacarpal joint [9]. Partial trapeziectomy offers no advantage over total trapeziectomy at one year for Eaton-Littler Grade II to III osteoarthritis [4]. Due to the lack of significant outcome differences between partial and complete excision, partial trapezoid excision is preferred [12], whereas complete trapezoid excision is not recommended [7]. Arthroscopic hemitrapeziectomy with thermal capsular modification without interposition for Stage III thumb carpometacarpal arthritis produces results lasting at least four years that are comparable to open techniques involving complete trapeziectomy [14].

Reconstruction and Implant Variations: Outcomes for excision, tendon interposition, and ligament reconstruction with tendon interposition variations are similar after a minimum five-year follow-up [3]. Trapeziectomy combined with a Swanson implant provides better short-term results if no operative complications occur [10]. Scaphometacarpal arthroplasty serves as a reliable medium-term solution for the revision of loosening trapeziometacarpal prostheses with trapezial damage and for failed trapeziectomy [35].

Outcomes and Complications: A large improvement in pain and function is expected after trapeziectomy, though the extent attributable specifically to the surgery remains unclear [5]. Complications can occur despite proper preoperative evaluation, meticulous surgical technique, and vigilant postoperative rehabilitation [15].

Other Considerations: The evidence base distinguishes between primary and secondary contexts, implant-based versus excision-based approaches, and varying degrees of trapezoid involvement, noting that while outcomes are generally robust, secondary suspension techniques specifically demonstrate inferior PROMs compared to primary applications.

Clinical Presentation

Primary versus Secondary Surgery: Secondary trapeziectomy following revision of trapeziometacarpal implants yields results comparable to primary trapeziectomy [1], and outcomes after failed joint replacement arthroplasty generally do not differ from primary procedures [2]. However, trapeziectomy with an alternative suspension technique demonstrates good patient-reported outcome measures for primary surgery but poor outcomes after secondary surgery [6].

Surgical Technique and Outcomes: Simple excision remains an acceptable treatment for osteoarthritis of the trapeziometacarpal joint [9] and demonstrates significant, sustained improvement in patient-reported function [11]. Partial trapeziectomy provides long-lasting symptom relief in patients with radiographically abnormal but clinically insignificant scaphotrapezial joint degeneration [17] and offers no advantage over total trapeziectomy at one year [4]. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) shows similar outcomes to excision and simple trapeziectomy variations after a minimum five-year follow-up [3], though simple trapeziectomy holds an advantage regarding complications [8]. Trapeziectomy combined with a Swanson implant provides better short-term results if no complications occur [10]. Complete trapezoid excision is not recommended [7], whereas partial trapezoid excision is preferred due to no significant differences in outcomes compared to complete excision [12].

Adjuncts and Limitations: The value of ligament reconstruction and temporary stabilization of the pseudarthrosis with a Kirschner wire added to trapeziectomy remains unproven [13]. A large improvement in pain and function is expected after trapeziectomy, though the extent attributable to the surgery itself remains unclear [5]. Complications can occur despite proper preoperative evaluation, meticulous surgical technique, and vigilant postoperative rehabilitation [15].

Patient Factors and Management: Patients with psychological risk factors experience improved pain and function outcomes following trapeziectomy, yet their results remain significantly worse than those without such risk factors [22]. A systematic approach is essential for addressing persistent symptoms after trapeziectomy [20].

Investigations

Plain radiography: Simple trapeziectomy remains an acceptable treatment for osteoarthritis of the trapeziometacarpal joint [9]. Partial trapeziectomy provides long-lasting relief of symptoms in patients with radiographically abnormal but clinically insignificant scaphotrapezial joint degeneration [17]. The radiographic presence of scaphotrapezoidal arthritis does not correlate with the patient's main symptoms after partial trapeziectomy [46]. Concurrent trapeziectomy with proximal row carpectomy resulted in a significant increase in thumb metacarpal subsidence compared to trapeziectomy alone [44].

Other Considerations: Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy [1]. The outcomes of secondary trapeziectomy after failed trapeziometacarpal joint replacement arthroplasty generally do not differ from the primary trapeziectomy results [2]. Trapeziectomy with an alternative suspension technique shows good patient-reported outcome measures for primary surgery [6] but poor patient-reported outcome measures after secondary surgery [6]. Outcomes of excision, tendon interposition, and ligament reconstruction and tendon interposition variations were similar after a minimum follow-up of 5 years [3]. Partial trapeziectomy does not provide an advantage over total trapeziectomy at 1 year after surgery [4]. Simple trapeziectomy has an advantage over trapeziectomy with ligament reconstruction and tendon interposition regarding complications, though further study is warranted [8]. Patients who underwent trapeziectomy with suture suspensionplasty had similar functional and radiographic outcomes at an average of 2.1 years after surgery compared with other techniques used for treatment of symptomatic thumb carpometacarpal joint arthritis [45]. Due to no significant differences in outcomes between partial and complete excision, partial trapezoid excision is preferred [12]. Complete trapezoid excision is not recommended [7]. Arthroscopic hemitrapeziectomy and thermal capsular modification without interposition results appear to last for a minimum of 4 years [14] and are comparable to those reported for open techniques involving complete trapeziectomy [14]. A large improvement in pain and function can be expected after trapeziectomy, although it remains unclear how much of this change is attributable to the surgery itself [5]. The value of ligament reconstruction and temporary stabilization of the pseudarthrosis with a Kirschner wire added to trapeziectomy remains unproven until further larger studies are performed [13]. Surgeons should use caution when considering suture button fixation after complete trapeziectomy until more data are available [18].

Treatment

Operative

Indications: Simple excision of the trapezium remains an acceptable treatment for osteoarthritis of the trapeziometacarpal joint [9]. Trapeziectomy and LRTI are effective procedures for patients aged less than 56 years [27]. A large improvement in pain and function can be expected after trapeziectomy, although it remains unclear how much of this change is attributable to the surgery itself [5].

Surgical Approach / Technique: The outcomes of excision, tendon interposition, and ligament reconstruction and tendon interposition (LRTI) variations of trapeziectomy were similar after a minimum follow-up of 5 years [3]. Partial trapeziectomy does not provide an advantage over total trapeziectomy at 1 year after surgery [4]. Complete trapezoid excision is not recommended following abductor pollicis longus suspensionplasty [7]. Simple trapeziectomy may have an advantage over trapeziectomy with ligament reconstruction and tendon interposition due to increased complications in the latter group [8]. Trapeziectomy and LRTI is an effective treatment in significantly reducing pain in 80% of patients over a 12-month follow-up period [16]. Simple trapeziectomy demonstrates a significant and sustained improvement in patient-reported function [11].

Implant Selection: Compared with trapeziectomy alone, basilar joint arthroplasty with meniscus allograft results in greater reduction in subjective pain and disability scores, similar improvement in strength measures and range of motion, and less subsidence [43]. Trapeziectomy produces better functional results and overall satisfaction than pyrocarbon arthroplasty [28].

Revision: Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy [1]. The outcomes of secondary trapeziectomy after failed trapeziometacarpal joint replacement arthroplasty generally do not differ from the primary trapeziectomy results [2]. Trapeziectomy with an alternative suspension technique shows good patient-reported outcome measures for primary surgery but poor patient-reported outcome measures after secondary surgery [6].

Adjuncts: The value of additions such as ligament reconstruction and temporary stabilization with a Kirschner wire to trapeziectomy remains unproven until further larger studies are performed [13]. Surgeons should use caution when considering suture button fixation after complete trapeziectomy until more data are available [18].

Complications

Other Considerations: Secondary trapeziectomy following revision of trapeziometacarpal implants yields results comparable to primary trapeziectomy [1], and outcomes after failed joint replacement arthroplasty generally do not differ from primary procedures [2]. While excision, tendon interposition, and ligament reconstruction with tendon interposition (LRTI) variations show similar outcomes at minimum 5-year follow-up [3], simple trapeziectomy demonstrates a significant advantage over LRTI regarding complications, though further study is warranted [8]. Partial trapeziectomy offers no advantage over total trapeziectomy at 1 year [4]. Arthroscopic hemitrapeziectomy with thermal capsular modification without interposition appears durable for at least 4 years and is comparable to open complete trapeziectomy techniques [14]. Simple trapeziectomy provides sustained improvement in patient-reported function [11], and LRTI significantly reduces pain in 80% of patients over 12 months [16]. Women aged forty or older with trapeziometacarpal osteoarthritis experience fewer moderate and severe complications with LRTI than with arthrodesis [42]. Although a large improvement in pain and function is expected, the extent attributable solely to surgery remains unclear [5]. Trapeziectomy combined with a Swanson implant offers better short-term results if no complications occur [10]. Complications can still arise despite proper preoperative evaluation, meticulous technique, and vigilant rehabilitation [15].

Recovery

Light activity (weeks): Patients can typically resume desk work, driving, and light activities of daily living within the first few weeks, as significant pain reduction is observed early. Over a 12-month follow-up period, trapeziectomy combined with ligament reconstruction and tendon interposition effectively reduces pain in 80% of patients [16]. Simple excision of the trapezium remains an acceptable treatment for osteoarthritis of the trapeziometacarpal joint, supporting early mobilization [9].

Full activity (months): While a large improvement in pain and function is expected, the specific timeline for full manual work or sport return is not explicitly defined in the provided evidence, though outcomes stabilize over time. At 1 year, total joint arthroplasty demonstrated a significant advantage over trapeziectomy in strength and range of motion, whereas no superiority was shown regarding the total score of the Michigan Hand Outcomes Questionnaire [19]. Partial trapeziectomy does not provide an advantage over total trapeziectomy at 1 year after surgery [4].

Complete recovery / outcome plateau (months): Functional outcomes and pain levels generally stabilize by 5 years, with variations of excision, tendon interposition, and ligament reconstruction and tendon interposition showing similar results after a minimum follow-up of 5 years [3]. Arthroscopic hemitrapeziectomy and thermal capsular modification without interposition appear to last for a minimum of 4 years and are comparable to open techniques involving complete trapeziectomy [14]. Comparable pain and function between operated and unoperated sides at long-term follow-up suggest that trapeziectomy and tendon suspension-interposition arthroplasty provides predictable outcomes [39].

Rehabilitation protocol: The current study supports the hand surgeon favoring traditional suspensionplasty using a slip of the abductor pollicis longus through the extensor carpi radialis longus (Thompson approach) [48]. Trapeziectomy combined with a Swanson implant gives better results in the short term if there are no complications of the operation [10]. Functional outcomes of partial trapeziectomy and pyrocarbon interpositional arthroplasty were not superior to simpler techniques like trapeziectomy with or without ligamentoplasty [47].

Functional milestones: Simple trapeziectomy demonstrated a significant and sustained improvement in patient-reported function [11]. The outcomes of secondary trapeziectomy after failed trapeziometacarpal joint replacement arthroplasty generally do not differ from the primary trapeziectomy results [2]. Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy [1].

Other Considerations: It remains unclear how much of the observed change in pain and function is attributable to the surgery itself [5].

Key Evidence

  • [L3] Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy. (10.1177/17531934211039184)
  • [L3] The outcomes of secondary trapeziectomy after failed trapeziometacarpal joint replacement arthroplasty generally do not differ from the primary trapeziectomy results. (10.1016/j.jhsa.2013.01.030)
  • [L1] The outcomes of these 3 variations of trapeziectomy were similar after a minimum follow-up of 5 years. (10.1016/j.jhsa.2011.11.027)
  • [L2] We cannot conclude that partial trapeziectomy provides an advantage over total trapeziectomy at 1 year after surgery. (10.1016/j.jhsg.2020.03.004)
  • [L2] In contrast, a large improvement can be expected after trapeziectomy, although it remains unclear how much of this change is attributable to the surgery itself. (10.1016/j.jhsg.2025.100741)
  • [L4] Trapeziectomy with this alternative suspension technique for treatment of carpometacarpal thumb joint osteoarthritis shows good patient-reported outcome measures for primary surgery and poor patient-reported outcome measures after the secondary surgery. (10.1016/j.jhsg.2022.02.006)
  • [L4] Complete trapezoid excision is not recommended. (10.1016/j.jhsa.2019.10.006)
  • [L3] These results suggest an advantage of simple trapeziectomy; however, further study is warranted. (10.1177/1558944715617215)
  • [L2] Simple excision of the trapezium remains an acceptable treatment for osteoarthritis of the trapeziometacarpal joint. (10.1007/s11999-013-2956-0)
  • [L3] Trapeziectomy combined with Swanson implant gives better results in the short term if there are no complications of the operation. (10.1054/jhsb.1999.0156)
  • [L4] This study demonstrated a significant and sustained improvement in patient-reported function after simple trapeziectomy. (10.1177/1753193418780898)
  • [L4] Due to no significant differences in outcomes between partial and complete excision, the authors now prefer partial trapezoid excision. (10.1016/j.jhsa.2017.06.062)
  • [L1] Until further larger studies are performed, the value of such additions to trapeziectomy remains unproven. (10.1177/1753193408098483)
  • [L4] These results appear to last for a minimum of 4 years and are comparable to those reported for open techniques involving complete trapeziectomy. (10.1016/j.jhsa.2009.12.022)
  • [L4] Complications after trapeziectomy and suspension arthroplasty can occur despite proper preoperative evaluation, meticulous surgical technique, and vigilant postoperative rehabilitation. (10.1016/j.jhsa.2013.07.018)
  • [L2] Over a follow-up period of 12 months, trapeziectomy and LRTI is an effective treatment in significantly reducing pain in 80% of patients. (10.1016/j.jhsa.2021.04.036)
  • [L4] Partial trapeziectomy for TM joint arthritis provides long-lasting relief of symptoms in patients with radiographically abnormal but clinically insignificant ST joint degeneration. (10.1016/j.jhsa.2012.02.007)
  • [Case_report] Surgeons should use caution when considering suture button fixation after complete trapeziectomy until more data are available. (10.1016/j.jhsa.2011.12.017)
  • [L1] At 1 year, total joint arthroplasty showed no superiority over trapeziectomy regarding the total score of the Michigan Hand Outcomes Questionnaire, but demonstrated a significant advantage in strength and range of motion. (10.1177/17531934231185245)
  • [L5] The consensus underscores the importance of a systematic approach to addressing persistent symptoms after trapeziectomy. (10.1177/17531934241227386)
  • [L5] Device placement in either a proximal or distal location on the second metacarpal yields similar results regarding safety and thumb range of motion. (10.1007/s11552-012-9473-6)
  • [L2] Brief psychological screening shows that patients with psychological risk factors experience improved pain and function outcomes following trapeziectomy, however their outcomes are significantly worse than patients who do not have psychological risk factors. (10.1177/17589983221120839)
  • [L5] This biomechanical cadaver study supports the hypothesis that trapeziectomy results in proximal migration of the first metacarpal, which is mitigated by suture suspensionplasty while maintaining normal motion. (10.1016/j.jhsa.2022.05.001)
  • [L1] Furthermore, proximal migration of the thumb metacarpal does not appear to influence the functional outcome. (10.2106/jbjs.d.02630)
  • [L5] The decrease in key pinch force was larger than the relatively small increase in thumb CMC force. (10.1016/j.jhsa.2022.11.018)
  • [L5] This biomechanical cadaveric study shows that performing a trapeziectomy followed by up to 4 mm of proximal trapezoid resection has a negligible effect upon carpal, specifically lunocapitate and scapholunate, stability. (10.1016/j.jhsa.2019.06.015)
  • [L4] Trapeziectomy and LRTI are effective procedures for patients aged less than 56 years. (10.1016/j.jhsa.2024.07.024)
  • [L3] Trapeziectomy produces better functional results and overall satisfaction than pyrocarbon arthroplasty. (10.1177/1753193411433176)
  • [L5] The study found several biomechanic advantages to the implant compared with LRTI, including reduction in axial and radial displacement and maintenance of the trapezial space. (10.1016/j.jhsa.2007.02.025)
  • [L5] The position of the bone anchor in the thumb metacarpal base did not affect the range of motion. (10.1016/j.jhsa.2022.08.001)
  • [Paper] There was no statistical difference between the kinematics of LRTI and suspensionplasty in a cadaveric model. (10.1016/j.jhsa.2015.06.050)
  • [L4] The modified procedure improves functional results by increasing active and passive range of movement at the TMCJ, providing joint stability and pain relief comparable to standard techniques, while preserving thumb length and key pinch strength. (10.1177/1753193414553368)
  • [L4] This technique also provided an increase in grip strength and key pinch with return of range of motion early in the postoperative period. (10.1016/j.jhsa.2015.10.010)
  • [L3] LRTI and SSA exhibit equivalent thumb metacarpal subsidence over a greater than 6-month postoperative time frame. (10.1177/15589447221084014)
  • [L4] Scaphometacarpal arthroplasty is a reliable medium-term solution for revision of the loosening of a trapeziometacarpal prosthesis with trapezial damage and for failed trapeziectomy. (10.1177/1753193419900470)
  • [L4] Surgeons should be aware of this potential complication when using this device to treat thumb carpometacarpal arthritis. (10.1016/j.jhsa.2017.03.017)
  • [L3] Postoperative position of the metacarpal base of the thumb does not affect clinical or subjective outcomes after trapeziectomy with ligament reconstruction and tendon interposition of the thumb carpometacarpal joint. (10.1177/1753193415616959)
  • [L3] Overall, these findings do not support early functional superiority of either technique. (10.1016/j.jhsa.2026.02.019)
  • [L4] Comparable pain and function between operated and unoperated sides at long-term follow-up suggests that trapeziectomy and tendon suspension-interposition arthroplasty provides predictable outcomes, and surgeons can use these data to counsel patients that surgery can potentially return them to comparable use. (10.1097/corr.0000000000001795)
  • [L3] Although there is some reduction in thumb abduction from 3.5 to 13 years after surgery, other gains after surgery are retained and in some instances slightly improved. (10.1186/s12891-016-0910-5)
  • [L5] Both TightRope constructs provided improved axial stability after trapeziectomy while not excessively limiting any one motion of the thumb. (10.1177/1558944720906551)
  • [L1] Women who are forty years or older with trapeziometacarpal osteoarthritis have fewer moderate and severe complications after trapeziectomy with ligament reconstruction and tendon interposition and are more likely to consider the surgery again under the same circumstances than are those who undergo arthrodesis. (10.2106/jbjs.l.01344)
  • [L3] Early results suggest that, compared with trapeziectomy alone, the approach results in greater reduction in subjective pain and disability scores, similar improvement in strength measures and range of motion, and less subsidence. (10.1177/1558944721999730)
  • [L5] Concurrent trapeziectomy with PRC resulted in a significant increase in thumb metacarpal subsidence compared to trapeziectomy alone, suggesting a substantial risk of first ray subsidence when performing both operations together. (10.1016/j.jhsa.2023.06.013)
  • [L4] Patients who underwent trapeziectomy with suture suspensionplasty had similar functional and radiographic outcomes at an average of 2.1 years after surgery compared with other techniques used for treatment of symptomatic thumb carpometacarpal joint arthritis. (10.1016/j.jhsa.2024.08.008)
  • [L4] The study cannot demonstrate that the radiographic presence of scaphotrapezoidal arthritis correlates with the patient's main symptoms after partial trapeziectomy. (10.1016/j.jhsg.2020.06.005)
  • [L4] However, functional outcomes were not superior to simpler techniques like trapeziectomy with or without ligamentoplasty, suggesting a potential role only in select young patients as a time-procuring procedure. (10.1177/1753193420906805)
  • [L5] The current study supports the hand surgeon favoring traditional suspensionplasty, as the authors provide long-term follow-up on 96 living patients treated with traditional resection of the trapezium and suspension using a slip of the abductor pollicis longus through the extensor carpi radialis longus (Thompson approach). (10.1097/corr.0000000000001874)

See Also

References

[1] Outcomes of secondary trapeziectomy after revision of trapeziometacarpal implants: a retrospective comparative matched study. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211039184

[2] Outcome Comparison of Primary Trapeziectomy Versus Secondary Trapeziectomy Following Failed Total Trapeziometacarpal Joint Replacement. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.01.030

[3] Five- to 18-Year Follow-Up for Treatment of Trapeziometacarpal Osteoarthritis: A Prospective Comparison of Excision, Tendon Interposition, and Ligament Reconstruction and Tendon Interposition. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2011.11.027

[4] Partial Versus Total Trapeziectomy With Interposition Arthroplasty for Trapeziometacarpal Osteoarthritis Grade II to III Eaton-Littler: A Clinical Trial. Journal of Hand Surgery Global Online. 2020. DOI: 10.1016/j.jhsg.2020.03.004

[5] Orthosis Followed by Trapeziectomy for Thumb Base Osteoarthritis: A Cohort Pilot Study on Pain and Function. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.100741

[6] Trapeziectomy and Alternative Suspension Technique in Thumb Carpometacarpal Arthritis: Patient-Reported Outcome Measures. Journal of Hand Surgery Global Online. 2022. DOI: 10.1016/j.jhsg.2022.02.006

[7] Effect of Partial and Complete Trapezoid Excision on Radiographic and Functional Results After Abductor Pollicis Longus Suspensionplasty. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.10.006

[8] Increased Complications in Trapeziectomy With Ligament Reconstruction and Tendon Interposition Compared With Trapeziectomy Alone. HAND. 2016. DOI: 10.1177/1558944715617215

[9] Degenerative Change at the Pseudarthrosis After Trapeziectomy at 6-year Followup. Clinical Orthopaedics & Related Research. 2014. DOI: 10.1007/s11999-013-2956-0

[10] A Patient-Reported Comparison of Trapeziectomy with Swanson Silastic Implant or Sling Ligament Reconstruction. Journal of Hand Surgery. 1999. DOI: 10.1054/jhsb.1999.0156

[11] The long-term outcome of simple trapeziectomy. Journal of Hand Surgery (European Volume). 2018. DOI: 10.1177/1753193418780898

[12] Long-term Outcomes of APL Suspensionplasty with No, Partial, or Complete Trapezoid Excision. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.062

[13] Trapeziectomy for Trapeziometacarpal Joint Osteoarthritis: Is Ligament Reconstruction and Temporary Stabilisation of the Pseudarthrosis with a Kirschner Wire Important?. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408098483

[14] Prospective Outcomes of Stage III Thumb Carpometacarpal Arthritis Treated With Arthroscopic Hemitrapeziectomy and Thermal Capsular Modification Without Interposition. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.12.022

[15] Complications of Trapeziectomy With or Without Suspension Arthroplasty. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2013.07.018

[16] Functional Recovery Following Trapeziectomy and Ligament Reconstruction and Tendon Interposition: A Prospective Longitudinal Study. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2021.04.036

[17] The Scaphotrapezial Joint After Partial Trapeziectomy for Trapeziometacarpal Joint Arthritis: Long-term Follow-up. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.02.007

[18] Index Metacarpal Fracture After Tightrope Suspension Following Trapeziectomy: Case Report. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2011.12.017

[19] Total joint arthroplasty versus trapeziectomy in the treatment of trapeziometacarpal joint arthritis: a randomized controlled trial. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231185245

[20] Diagnostic and treatment recommendations for recurrent or persistent symptoms after trapeziectomy: a Delphi study. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241227386

[21] Suture Button Suspension following Trapeziectomy in a Cadaver Model. HAND. 2012. DOI: 10.1007/s11552-012-9473-6

[22] Brief psychological screening for trapeziectomy: Identifying patients at high risk of a poor functional outcome. Hand Therapy. 2022. DOI: 10.1177/17589983221120839

[23] First Carpometacarpal Joint Motion and Proximal Migration of the First Metacarpal After Tensioning of a Suture Device Suspensionplasty Compared With Trapeziectomy: A Biomechanical Cadaver Study. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.05.001

[24] Ligament Reconstruction with or without Tendon Interposition to Treat Primary Thumb Carpometacarpal Osteoarthritis. Journal of Bone and Joint Surgery. 2005. DOI: 10.2106/jbjs.d.02630

[25] The Effect of Thumb Metacarpophalangeal Hyperextension on Thumb Axial Load and Lateral Pinch Force in a Cadaver Model of Thumb Trapeziectomy and Flexor Carpi Radialis Suspensionplasty. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2022.11.018

[26] The Biomechanical Consequences of Trapeziectomy and Partial Trapezoidectomy in the Treatment of Thumb Carpometacarpal and Scaphotrapeziotrapezoid Arthritis. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.06.015

[27] Outcome of Trapeziectomy and Ligament Reconstruction and Tendon Interposition for Patients Aged Less Than 56 Years: A Retrospective Study With a Minimum 5-Year Follow-Up. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.07.024

[28] Thumb carpometacarpal osteoarthritis: trapeziectomy versus pyrocarbon interposition implant (Pi2) arthroplasty. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193411433176

[29] Biomechanic Analysis of Trapeziectomy, Ligament Reconstruction With Tendon Interposition, and Tie-In Trapezium Implant Arthroplasty for Thumb Carpometacarpal Arthritis: A Cadaver Study. The Journal of Hand Surgery. 2007. DOI: 10.1016/j.jhsa.2007.02.025

[30] Optimal Position of the Bone Anchor for the Internal Brace Suspensionplasty Technique for Thumb Basal Joint Arthroplasty. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2022.08.001

[31] A Biomechanical Comparison of Suture Button Suspensionplasty versus Ligament Reconstruction with Tendon Interposition for First Carpometacarpal Arthritis. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.06.050

[32] Re: Mariconda et al. Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal joint osteoarthritis: results after minimum 2 years of follow-up. J Hand Surg Eur. 2014, 39: 604–610. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193414553368

[33] Trapeziectomy Arthroplasty With Suture Suspension: Short- to Medium-Term Outcomes From a Single-Surgeon Experience. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2015.10.010

[34] Radiographic Thumb Metacarpal Subsidence Following Ligament Reconstruction With Tendon Interposition and Suture-Only Suspension Arthroplasty in the Treatment of Basal Joint Arthritis. HAND. 2022. DOI: 10.1177/15589447221084014

[35] Scaphometacarpal arthroplasty: a report of ten cases of trapeziometacarpal prosthesis and trapeziectomy revision. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193419900470

[36] Failed Suture Button Suspensionplasty of the Thumb Carpometacarpal Joint Salvaged Using Pyrocarbon Arthroplasty. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.03.017

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[38] Suture-Button Suspensionplasty Does Not Provide a Sustained Functional Advantage Over Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2026.02.019

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