Introduction Arthritis of the trapeziometacarpal joint of the thumb is a common ailment causing crippling pain and weakness of the basilar joint. Treatment involves excision of the trapezium followed by reconstructive arthroplasty. Several techniques have been described using tendon as a sling or interposition in order to reconstruct the basilar joint.

Methods We retrospectively analyzed the results of 26 thumbs treated with one of two different techniques commonly employed at our institution. A modification of the Weilby FCR suspension-plasty was performed in 13 cases and the Thompson APL sling arthroplasty in 13. All surgeries were performed by a single surgeon between 10/2001 and 12/2004

Results All patients had improvement in ROM and 23 of 26 (88%) had significant resolution of pain at last follow up. Time to resolution of symptoms and return to work were significantly shorter in the APL sling arthroplasty group (14 and 10 weeks vs. 25 and 21 weeks). Functional evaluation of grip, key and pinch strength demonstrated return of >85% of the strength of the non-operated side in 86% of patients with no significant difference between the two groups.

Discussion These results demonstrate resolution of pain and recovery of strength in the majority of patients treated with either technique although APL sling arthroplasty patients returned to work sooner.