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

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).