Introduction and Background
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
Thumb CMC Suspensionplasty
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.
Innovation and Advantages
2 Drivers 2 Drills
That’s it
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.
Jeanne L. DelSignore, MD is a retired orthopedic hand surgeon with more than 40 years of experience specializing in the care of the upper extremity, including the hand, wrist, and forearm. Throughout her distinguished career, she was recognized for her expertise in both surgical and non-surgical treatment of complex hand and wrist conditions, helping generations of patients regain function and quality of life.
Dr. DelSignore earned her Doctor of Medicine degree from the University of Rochester School of Medicine & Dentistry in 1983 and completed her orthopedic surgery residency training at Strong Memorial Hospital in Rochester, New York. She is board certified in Orthopaedic Surgery and Hand Surgery.
For over four decades, Dr. DelSignore practiced in Rochester as a member of Hand Surgery Associates, LLP, with affiliations to Strong Memorial Hospital and Rochester General Hospital. She also made history as the first female orthopaedic surgery attending physician in the Rochester region within the University of Rochester’s Department of Orthopaedics, paving the way for future generations of women in the specialty.
Her clinical focus included treatment of carpal tunnel syndrome, trigger finger, thumb CMC arthritis, wrist fractures, tendon and ligament injuries, and complex upper-extremity reconstruction. She is especially known for her work in arthritic hand disorders and innovative surgical techniques for thumb arthritis.