TechniquesAnatomic Reconstruction of the Anterior Oblique and the Dorsoradial Ligaments for Painful Subluxating Carpometacarpal Joint of the ThumbBryant, Benjamin S.H. MD*; Butler, Katherine A. MD*; Marsh, Kathleen A. BS*; Wiesler, Ethan R. MD*; Li, Zhongyu John MD, PhD*; Warburton, Mark J. MD† Author Information *Department of Orthopedics, Wake Forest Baptist Medical Center, Wake Forest University, Winston-Salem †Wake Forest Baptist Orthopedics and Sports Medicine, High Point, NC The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Benjamin S.H. Bryant, MD, Wake Forest School of Medicine, 475 Vine St, Winston-Salem, NC 27101. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: September 2021 - Volume 25 - Issue 3 - p 148-155 doi: 10.1097/BTH.0000000000000324 Buy Metrics Abstract Thumb carpometacarpal osteoarthritis (CMC OA) is a common pathology of the hand that is characterized by pain, loss of grip and pinch strength, and deformity. Although conservative management is often preferred in earlier stage of CMC OA, surgical techniques can be used when symptoms are not fully relieved, especially with subluxation. We report a case series of 26 patients (32 operations) with Eaton stage I and II CMC OA who underwent a novel surgical technique that anatomically restores the CMC joint with autologous double ligament reconstruction. All cases were retrospectively reviewed as a prospective study and performed at a single regional health system from 2012 to 2016. Preoperative and postoperative radiographs, grip and pinch strength measurements, and DASH scores were collected to evaluate the outcomes. The mean CMC subluxation ratio decreased from 0.59±0.14 to 0.35±0.21 (P<0.0001). The mean grip strength increased from 44.34±17.36 pounds to 52.97±18.92 pounds (P=0.017), and the mean pinch strength increased from 10.16±4.59 pounds to 12.75±4.52 pounds (P=0.00027). The mean DASH scores decreased from 42.32±14.99 to 19.94±14.47 (P<0.0001). The average follow-up period was 39.44±14.94 months. Three patients had postoperative thumb stiffness that resolved with physical therapy. One patient had postoperative pain, attributed to carpal tunnel syndrome. One surgery required revision. All other patients (84.38%) reported significant improvement in pain and the ability to return to previous levels of work. This surgical technique is therefore a feasible option for patients with Eaton stage I or II CMC OA, and should be recommended for wider surgical use. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.