79 women undergoing trapeziectomy with ligament reconstruction and tendon interposition due to stage IV trapeziometacarpal osteoarthritis (OA) were randomized to undergo surgery using either the Burton-Pellegrini technique with a bone tunnel, or the Weilby technique without a bone tunnel. The purpose of this study was to determine whether one technique was advantageous over the other in terms of pain and functional improvement over a 5 year follow-up period. Both techniques were found to produce similar patient outcomes, as no significant differences in pain, function, strength, patient satisfaction or incidence of post-operative complications were found between groups at both 1 year and 5 years following surgery.