[Prosthetic replacement of the first carpometacarpal joint with a cemented ball and socket prosthesis (de la...

We analysed the fate of 43 de la Caffinière prostheses implanted for arthrosis of the first carpometacarpal joint after a follow-up of 63 months (range 45 to 81). Ten prostheses failed. Further eight patients were lost for follow up. In the remaining 25 patients the rate of tilting of the cups (92%) was extremely high and the survival rate disappointing: 66% at 68 months. The prostheses were implanted in cancellous bone and the ball and socket reduces the moving axes of the normal joint to one center of rotation. These factors might explain the higher rate of loosening of the cups (28%), compared to 15% for the stems. In contrast, the clinical results were comparable with other operative procedures. The advantage is the brief postoperative rehabilitation period. Accordingly, this prosthesis can not be universally recommended and should be reserved for elderly patients, who must not undertake strenuous work.