To The Editor:In their article "Ligament Reconstruction with or without Tendon
Interposition to Treat Primary Thumb Carpometacarpal Osteoarthritis. A
Prospective Randomized Study"
(2004;86:209-18), Kriegs-Au et
al. concluded that the degree of proximal migration of the thumb metacarpal
may have no effect on postoperative thumb strength, function, and pain. At the
time of final follow-up, there was proximal migration of the thumb metacarpal
compared with the position seen at both the preoperative visit and the initial
postoperative visit. Since this does not appear to affect ultimate outcome, we
would be interested in learning the authors' opinion regarding the role and
utility of ligament reconstruction. Why not perform trapezial resection alone
(without ligament reconstruction or tendon interposition)?