Why ligament reconstruction, tendon interposition arthroplasty fails, and salvaging failed ligament reconstruction, tendon interposition arthroplasty

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Abstract

Purpose of review

As our population ages, patients with arthritic basilar thumb joints will become an ever-increasing part of the practices of those treating hand problems. The gold standard for the surgical treatment of basilar thumb arthritis is the ligament reconstruction, tendon interposition arthroplasty. While the majority of patients undergoing this procedure have good to excellent results, failures do occur both acutely and over the course of time. This review explores the reasons for failure, incorporating recent published articles, and examines the treatment options for salvaging the failed ligament reconstruction, tendon interposition.

Recent findings

There is a paucity of literature specifically on failure of ligament reconstruction, tendon interposition procedures, most likely because the procedure often produces good results. Most commonly, failed ligament reconstruction, tendon interposition procedures are discussed within the body of studies reporting on the overall good results of the procedure. Of the articles published on ligament reconstruction, tendon interposition procedures during the last few years, subjective failures have been reported as due to night pain and severe weakness. Objective failures have been reported due to sensory nerve problems and reflex sympathetic dystrophy.

Summary

The ligament reconstruction, tendon interposition procedure usually produces good results. Failures have a multitude of etiologies, some of which can be salvaged by directing treatment at specific mechanical/technical factors that produced the failed result.

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