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Published on: January 24, 2018
[Longevity factors in total trapezometacarpal prostheses]
1Service d'orthopédie, Centre Hospitalier de Saint Denis, 2, Rue Dr Delafontaine, Saint Denis 93205, France.
Chirurgie De La Main
|April 9, 2001
Summary
Long-term outcomes of cemented trapeziometacarpal prostheses show success when preserving first ray length. Careful patient selection and surgical approach are crucial for optimal results in thumb arthritis treatment.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Context:
- Trapeziometacarpal joint arthritis significantly impacts hand function and quality of life.
- Total joint arthroplasty offers a treatment option for advanced cases.
Purpose:
- To evaluate the long-term outcomes of cemented ball and socket trapeziometacarpal prostheses.
- To identify critical factors influencing prosthesis survival and functional restoration.
Summary:
- A series of 13 patients received cemented metal-on-polyethylene trapeziometacarpal prostheses with modifications to enhance fit and restore first ray length.
- Long-term follow-up (12-17 years) assessed functional outcomes and identified potential complications such as component loosening.
- Maintaining or re-establishing the length of the first ray emerged as a primary principle for successful outcomes.
Impact:
- This study highlights the importance of preserving first ray length and careful patient selection for trapeziometacarpal prosthesis longevity.
- Findings guide surgical decision-making, emphasizing prosthesis use as a last resort for severe pain and contraindicating intensive use in dominant hands.
- Recommendations include a posterior surgical approach for optimal component positioning and preservation of surrounding ligaments.
