Mersilene Suspension for Thumb Reconstruction

The thumb is the most important part of a hand. Problems with the thumb, such as pain and loss of motion, have devastating effects on hand function. Arthritis at the base of the thumb is, unfortunately, the most common type of degenerative arthritis (osteoarthritis) seen in the hand. Treatment of this problem includes hand therapy (exercise program, protective and supportive splints, arthritis education…), medication, steroid injections and surgery. The only definitive treatment is surgery.

The good news is that surgery for thumb arthritis is quite successful. Usually a diseased joint is either fused or replaced. A joint fusion produces a solid, strong, joint which cannot move. The loss of motion may not be a problem if there are other joint in that area, which can take over the function of the fused joint. Another alternative is to replace the joint with an artificial joint. No joint has ever been made that lasts for ever. The results of joint replacement vary a great deal according to which joint specifically is being replaced.

A great solution for the base of the thumb is to combine the advantages of many past procedures. Namely, use an operation which would remove the arthritic bone (as done with joint replacement) and provide stability (as done with fusion). This way we can obtain a stable, painless thumb that still moves! This approach is not new, but a new procedure was developed at the Pennsylvania Hand Center using these principles.

Mersilene Suspension Arthroplasty consists in removing the trapezium bone (source of the problem) and using a polyester ribbon to suspend and stabilize the thumb metacarpal. We have used this procedure exclusively for over 5 years, with great success. It should, however, still be considered experimental to a certain degree, because it is still not widely known or used. We also believe that there is no better alternative at this time.