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Our goal, when developing the Anchor Line Fixation System for Thumb CMC repair was to create a stable, reproducible repair, with bone-to-bone fixation of a suture suspension sling, built on the long-term clinical success of the Suture Suspension Arthroplasty (SSA), developed by Jeanne DelSignore, MD.(1) This method is widely adopted and regarded as one of the preferred methods of less invasive treatment for thumb CMC arthritis reconstruction. The ASSH podium presentation of the 12-14 year follow-up of this method was chosen for the prestigious 2021 Sumner Koch Award: Presented to the author(s) of the presentation at the annual meeting of the American Society for Surgery of the Hand judged to have "the greatest future clinical application to the practice of hand surgery." (2)
1. DelSignore, J.L., Accardi, K.Z. Suture Suspension Arthroplasty Technique for Basal Joint Arthritis Reconstruction. Techniques in Hand and UpperExtremity 2009 Vol 13 (4)
2. DelSignore J.L, Zambito K, Ballatori S.E. Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up. HAND 2020; Vol 18. Issue 1 https://doi.org/10.1177/15589447211003176
The principles of Suture Suspension Arthroplasty are to suspend the thumb following trapeziectomy and tether the base of the thumb metacarpal towards the base of the index metacarpal. This suture construct corrects subluxation deformity, maintains arthroplasty space, and recreates a more normal 1st web space angle, which aids in normalized thumb function. As a pure soft tissue procedure SSA relies on the integrity of soft tissue attachments of the suture suspension sling, carrying with it, inherent risks of requiring a precise suture placement technique-placing the suture sling as distally as possible, avoiding tearing through soft tissue by grasping the deep FCR subsheath, and placement of locking sutures into the FCR insertion. In short, it is limited in its reproducibility among surgeons. In addition, if the soft tissue is of poor quality, it may not be sufficient to expect adequate fixation. For patients with heavy functional demands, severe deformity, or revision surgery, SSA alone is not recommended, as some form of bony fixation of the suture suspension sling is considered as a more robust option.
Simparo Surgical’s Anchor Line Fixation System is unique in that it is an intra-articular reconstruction, performed through a single incision with no exposed hardware, no need for cumbersome multiple suture strands, no need for tendon harvesting and weaving into the suspension sling, and more reliable titanium suture anchor fixation, featuring aggressive cancellous thread design with suture anchors placed into the base of the index metacarpal facet, just radial to the FCR insertion, and the intra-articular base of the thumb metacarpal.This is designed to create a more anatomic reconstruction of the CMC joint to optimize function.
Our proprietary cinching and tensioning device, the Falcon Suture Clutch, provides for controlled tensioning of the suspension sling until appropriate then reinforced with knots in the suture. Approximation of the base of the thumb metacarpal towards the base of the indexmetacarpal is achieved, supported with a stable suspension sling during healing. This method can allow for an early return to passive motion (within 2 weeks) leading to a faster return to normal function. This can reduce operative time by as much as 67% over a traditional LRTI.
