This study aims to compare the clinical and radiological outcomes of adding FCR-APL tenodesis to suture-button suspensionplasty following trapeziectomy in the treatment of Basal Joint Osteoarthritis (BJOA).This study is based on a prospectively collected cohort, comparing patients treated with trapeziectomy and suture-button suspensionplasty, with (n=14) or without (n=18) additional APL-FCR suspensionplasty, followed until one month postoperatively. Mid-term outcomes were assessed through retrospective analysis of 29 patients who returned for a routine follow-up more than 12 months after surgery. Outcomes included trapezial space ratio (TSR), patient-reported pain (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), range of motion (ROM), and return-to-work time.Both groups demonstrated significant improvements in pain and all functional outcomes, with no significant difference between the groups in DASH, PRWE, and VAS scores as well as in ROM limitation or return-to-work time. TSR reduction was observed in both groups, but there was no significant difference in subsidence between the two. Minor complications occurred in both groups.Both surgical techniques improved patient-reported outcomes. However, the addition of APL-FCR suspensionplasty to suture-button suspensionplasty did not significantly reduce the subsidence of the first metacarpal bone or improve functional results.