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. 2025 Jul;50(7):884.e1-884.e9.
doi: 10.1016/j.jhsa.2024.05.005. Epub 2024 Jun 27.

Patient-Reported and Clinical Outcomes After Tendon Autograft Reconstruction of the Thumb Ulnar Collateral Ligament

Ingmar W F Legerstee  1 , Mark J W van der Oest  2 , J Sebastiaan Souer  3 , Caroline A Hundepool  2 , Liron S Duraku  4 , Ruud W Selles  5 ; Hand-Wrist Study Group; J Michiel Zuidam  2
Collaborators, Affiliations
Free article

Patient-Reported and Clinical Outcomes After Tendon Autograft Reconstruction of the Thumb Ulnar Collateral Ligament

Ingmar W F Legerstee et al. J Hand Surg Am. 2025 Jul.
Free article

Abstract

Purpose: This study aimed to report clinical and patient-reported outcomes collected in a registry after thumb ulnar collateral ligament (UCL) reconstruction with a free tendon autograft. Furthermore, the patient-reported outcomes of patients with persistent instability after reconstruction and patients with concomitant metacarpophalangeal joint arthritis diagnosed during surgery were analyzed.

Methods: Patients undergoing reconstruction with a tendon autograft between December 2011 and February 2021 were included. Michigan Hand Outcomes Questionnaire (MHQ) scores at baseline were compared with those at 3 and 12 months after surgery. Stability was tested at 3 months after surgery. Tip and key pinch strength and metacarpophalangeal joint range of motion were measured at baseline and 12 months after surgery.

Results: We included 31 patients with thumb UCL insufficiency or failed UCL surgery who underwent reconstruction. The MHQ total score improved significantly from 62 at baseline to 75 at 3 months and continued to increase to 84 at 12 months after surgery. The MHQ function and pain scores improved significantly from intake to 3 and 12 months after surgery. Twenty-six of 31 patients (84%) regained postoperative metacarpophalangeal stability. Key pinch strength improved significantly 12 months after surgery from 5.2 kg at baseline to 6.4 kg at 12 months. The MHQ total, pain, and function scores of patients with persistent instability remained similar from baseline to 12 months after surgery. In four patients with metacarpophalangeal arthritis, the MHQ total and pain score improved significantly from baseline to 3 and 12 months after surgery.

Conclusions: Patient-reported outcomes, including pain and function, improved after thumb UCL reconstruction with a tendon autograft. Although the sample size of patients with thumb metacarpophalangeal arthritis diagnosed during surgery was small, they reached adequate patient-reported outcomes at 12 months after surgery.

Type of study/level of evidence: Therapeutic IV.

Keywords: Michigan hand outcomes questionnaire; PROMs; skier’s thumb; surgical reconstruction; thumb UCL injury.

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Conflict of interest statement

Conflicts of Interest Dr Legerstee received financial support from Anna Fonds the Netherlands, Michaël -van Vloten Fonds the Netherlands, and Prins Bernhard Cultuurfonds the Netherlands. These foundations were not involved in the conduct and preparation of the article. No benefits in any form have been received or will be received by the other authors related directly to this article.

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