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What is Thumb CMC Arthroplasty (suspensionplasty) with MicroLink™ Suture Button?

Thumb CMC (carpometacarpal) arthroplasty, particularly with suspensionplasty using the MicroLink™ Suture Button by ConMed, is a surgical technique designed to treat thumb CMC arthritis. This method preserves thumb mobility and stability by suspending the first metacarpal after removing the arthritic trapezium bone, using the suture button system for secure fixation.

In the thumb, the CMC joint is formed from two bones, the metacarpal and trapezium, and allows the hand to grasp objects with a strong grip. Thumb CMC arthritis, also known as basal joint arthritis, is a common condition that affects the joint at the base of the thumb where the metacarpal bone meets the trapezium bone in the wrist. It occurs when the cartilage in this joint wears away, leading to pain, stiffness, and decreased hand function.

Indications for Thumb CMC Arthroplasty (suspensionplasty) with MicroLink™ Suture Button

Thumb CMC arthroplasty (suspensionplasty) with MicroLink™ suture button (ConMed) is typically indicated for:

  • Patients with advanced thumb CMC joint arthritis (osteoarthritis or post-traumatic arthritis) who experience significant pain, weakness, and reduced function.
  • Patients with failure of conservative treatments, such as splinting, NSAIDs, or steroid injections in relieving symptoms associated with thumb CMC arthritis.
  • Patients who want to preserve thumb motion and strength while avoiding more invasive or traditional procedures for thumb CMC arthritis.

Key Components of Thumb CMC Arthroplasty (suspensionplasty) with MicroLink™ Suture Button Procedure

Key components of the procedure:

CMC Arthroplasty

  • The arthritic joint at the base of the thumb (first CMC joint) is reconstructed by removing the damaged cartilage and a small portion of the trapezium bone.
  • This step eliminates the painful bone-on-bone contact.

Suspensionplasty

  • A technique used to suspend and stabilize the thumb metacarpal bone (the first metacarpal) in place after the trapezium is removed or partially resected.
  • Traditionally, this was done using a tendon graft, but newer techniques utilize implants.

MicroLink™ Suture Button

  • A suture-button implant that acts as a stabilizing bridge between the thumb metacarpal and adjacent bones.
  • The implant consists of a strong suture loop and two small buttons that hold the bones in position without the need for tendon grafts.
  • This preserves surrounding soft tissue and avoids donor site morbidity (damage to the area where a tendon might have been harvested).

Surgical Procedure for Thumb CMC Arthroplasty (suspensionplasty) with MicroLink™ Suture Button

In general, the procedure is typically performed under regional or general anesthesia and involves the following steps:

  • A small incision is made over the base of the thumb to access the CMC joint.
  • The arthritic parts of the joint are cleaned, and portions of the trapezium may be resected (removed).
  • A small drill hole is made in the base of the first metacarpal (thumb bone) and a corresponding point in the scaphoid or another adjacent stable bone.
  • The MicroLink™ Suture Button is inserted and secured with the suture loop and buttons to stabilize the thumb base.
  • The implant suspends the thumb, maintaining proper spacing and alignment while healing occurs.
  • If necessary, soft tissues like tendons may be reinforced or reconfigured to further enhance joint stability.
  • The incision is closed with sutures, and a sterile dressing is applied.

Postoperative Care and  Recovery

Postoperative care following thumb CMC arthroplasty with the MicroLink™ suture button focuses on ensuring proper healing and restoring thumb function. The thumb and wrist are immobilized in a splint or cast for 4–6 weeks to protect the repair and minimize movement. Pain and swelling are managed with prescribed or over-the-counter medications, anti-inflammatories, and ice packs. The surgical site should be kept clean and dry, with any dressing changes or suture care guided by the surgeon. Rehabilitation begins with gentle range-of-motion exercises around 4–6 weeks post-surgery, progressing to strengthening exercises by 6–12 weeks under the supervision of a physical therapist. Patients are advised to avoid heavy lifting or gripping activities until cleared by the surgeon, with full recovery typically achieved within 3–4 months. Regular follow-up appointments are essential to monitor healing and evaluate the stability of the MicroLink™ Suture Button (ConMed).

Advantages of Thumb CMC Arthroplasty (suspensionplasty) Using MicroLink™ Suture Button

Benefits of using the MicroLink™ suture button (ConMed) include:

  • Enhanced Stability: Provides robust fixation and prevents excessive movement of the thumb metacarpal.
  • Minimally Invasive: The device reduces the need for bulky soft tissue reconstruction, which shortens recovery time.
  • Durability: The suture button material is designed to withstand the forces applied during thumb use.
  • Simplifies Procedure: Eliminates the need for tendon harvesting.
  • Improved Function: Maintains thumb range of motion while relieving pain.

Risks and Complications

Risks and complications associated with thumb CMC arthroplasty with the MicroLink™ suture button include:

  • Infection
  • Nerve injury
  • Device complications
  • Pain or stiffness
  • Joint instability
  • Tendon irritation or damage
  • Allergic reactions
  • Anesthesia-related risks
Practice Locations
Thomas Neustein, M.D. Practice Locations
Specialty
Orthopaedics

81 Prominence Court
Suite 100
Dawsonville, GA 30534

Practice Hours: 8 am - 5 pm
Specialty
Orthopaedics

1229 Friendship Road
Suite 100
Braselton, GA 30517

Practice Hours: 8 am - 5 pm
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