[The Roseland prosthesis in the treatment of osteoarthritis. A five years experience with the same surgeon]

The results of the Roseland trapeziometacarpal prosthesis in the treatment of the TMP arthritis has been reviewed and the trapezial component fixation discussed.

The material has been collected between November 1995 and January 2000. The immobilisation lasted 15 days if the prosthesis was cemented and one month if not. The following criteria were studied: pain, opposition, first and the second metacarpal angle, patient satisfaction, X-rays data, surgeon opinion on the components position, complication and re-operation.

The series is made of 45 cases (43 patients), eight males and 37 females. The average age was 59.7 years, with an average pre-operative duration of 3.5 years. X-rays data shows 43% with Dell II and 33% with Dell III aspect. 19 prosthesis were cemented, 22 not, 9 cases had a mixed fixation. The average follow up is 14 months. There was no or few post-operative pain (74% of cases). The opposition has been improved in most of the cases. 78% of the patients were satisfied. Post-operative X-rays were correct in 66% for the trapezial component and in 86.5% with the metacarpal one. There were 12 complications, with eight trapezial component failures. Eight patients were re-operated on. All cases were satisfying then.

If some foreign causes occurred in some complication, six failures were due to a technical problem. We must point out the frequency of failure with the cemented trapezium. However, the Roseland prosthesis is a satisfying arthroplasty but the trapezial component implantation must be improved.