Introduction: Ligament Reconstruction Tendon Interposition Arthroplasty (LRTI) for basal joint arthritis of the thumb is a well-proven technique with a history of excellent results. One of the most difficult points of the surgery is the creation of a transosseous tunnel in the base of the first metacarpal and passage of the flexor carpi radialis (FCR) tendon through this tunnel. Complications include intraoperative or postoperative fracture through the bone tunnel, unreliable placement of the tendon anchor site to the first metacarpal using a drill, and difficulty passing the tendon through the tunnel. We present a new, slightly modified technique for LRTI arthroplasty utilizing suture anchors that simplifies the operation, eliminates some complications, and saves operative time by eliminating the need for a transosseous tunnel. Purpose: A follow-up study was performed to determine the clinical outcome of the new technique, termed Suture Anchor Arthroplasty (SAA). Methods: _16 consecutive patients presented _18 hands, all of which underwent SAA utilizing suture anchors. Each hand was assessed with a standardized physical exam, radiographs, patient satisfaction, grip strength, and key pinch strength pre-operatively and at follow-up. Results: After an average follow-up period of 15 months (range 5-41 months), all thumbs were stable by exam and had relief of pain. 15 of 16 (_94% ) patients were satisfied. All patients would have the surgery again if given the choice. Grip strength improved by 66% and key pinch strength increased by 34% compared to preoperative values. Loss of the trapezial space height averaged 35% by radiographs. There were no suture anchor failures and no patients needed reoperation. Discussion and Conclusion: SAA gives excellent clinical results comparable to all past studies of the LRTI arthroplasty for thumb carpometacarpal osteoarthritis. There is no transosseous tunnel needed in the first metacarpal, so dorsal exposure of the first metacarpal is avoided, bone tunnel complications are avoided, and no time is wasted making the tunnel or passing the FCR tendon. Precise anchoring of the FCR tendon to recreate a sling effect in the direction of the palmar oblique (beak) ligament is also made easier with the use of suture anchors. Overall, the use of suture anchors in the first metacarpal simplifies the LRTI procedure, prevents some complications, and saves operative time.