Hand Ligament Reconstructions With Knee Collateral Ligament Allografts

The purpose of this study is to review the clinical outcomes following hand ligament reconstruction surgery using allograft (cadaveric) knee collateral ligaments. Currently, there is no standard procedure or devices used for hand ligament reconstruction surgery, although most techniques use some form of autograft (patients' own tissue) for the reconstruction. We believe that the use of allograft ligaments in reconstruction may eliminate the pain associated with procuring the patients' own tissue for the procedure, and prove to be a viable and preferred alternative to the multiple techniques currently used. The main procedures of this study include wrist and hand ligament reconstruction surgery (for wrist scapholunate (SL) ligaments, thumb ulnar collateral ligaments (UCL), and finger proximal interphalangeal (PIP) joint collateral ligaments) using allograft ligament, and subsequent follow up appointments where measurements and questionnaires will be completed to evaluate how hand function is doing after surgery.

All patients enrolled in the study will undergoing their ligament reconstruction procedure with allograft ligament.

Participants will undergo surgery for hand and wrist ligament reconstruction using allograft ligament.

Change from baseline in functional outcome, as measured by the quick Disabilities of the Arm, Shoulder and Hand (qDASH) questionnaire

The qDASH questionnaire asks about symptoms of upper extremity disability as well as the ability to perform certain activities. It generates a score from 0 to 100, with higher scores indicating greater severity of disability.

The VAS generates a scale from 0 to 100 with 0 indicating no pain and higher scores indicating greater pain.

Range of motion to be assessed includes wrist extension, wrist flexion, wrist ulnar deviation, wrist radial deviation, finger proximal interphalangeal joint flexion and extension, thumb metacarpophalangeal joint flexion and extension, thumb abduction and adduction.

Radiographic images obtained can help indicate the success of surgery by demonstrating joint stability.

Inclusion Criteria: Provision of signed and dated informed consent form Stated willingness to comply with all study procedures and availability for the duration of the study Have symptomatic injuries to either their finger PIP collateral ligaments, thumb UCL ligaments, or wrist SL ligaments and have failed non-operative management for the above ligament injuries (thus eligible for operative reconstruction) Age over 18 years Exclusion Criteria: Presence of any other current injury in that limb Presence of advanced arthrosis in that limb Presence of fixed joint deformity in that limb Presence of instability in that limb due to bony or articular instability Presence of instability in that limb due to inflammatory arthrosis Is under 18 years of age Lacks the capacity to consent