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[Guepar anatomical trapeziometacarpal prosthesis].
E Masmejean1, J Y Alnot, C Chantelot
1Hôpital européen Georges-Pompidou (HEGP), service de chirurgie de la main et du membre supérieur (Pr J.-P. Lemerle), 20, rue Leblanc, 75908 Paris, France. emmanuel.masmejean@hop.egp.ap-hop-paris.fr
Chirurgie De La Main
|May 2, 2003
Summary
Guepar total arthroplasty effectively treats trapeziometacarpal Osteo-Arthritis (OA) by preserving thumb length and improving pinch strength. This study shows excellent clinical and stable radiological outcomes for this prosthesis in OA patients.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Reconstructive Surgery
Background:
- Trapeziometacarpal (TMC) Osteo-Arthritis (OA) treatment involves various surgical techniques.
- Total arthroplasty is a common approach, particularly in France, with numerous prostheses described.
- English literature shows less widespread use of these devices.
Purpose of the Study:
- To report preliminary results of the Guepar total arthroplasty for TMC Osteo-Arthritis.
- To evaluate the clinical and radiological outcomes of this specific prosthesis design.
Main Methods:
- Utilized cemented, metal-polyethylene, ball-in-socket Guepar prostheses with anatomical stems.
- Implanted in elderly patients with Dell stage III or IV TMC OA after conservative treatment failure.
- Reported preliminary outcomes for 64 implanted prostheses since 1995.
Main Results:
- Presented results for 63 prostheses with a mean follow-up of 29 months.
- Achieved excellent or good clinical results in all cases, with one failure due to loosening.
- Observed no radiological modifications in 56 cases; noted minor radiolucent lines in six without clinical impact.
Conclusions:
- TMC arthroplasty provides pain relief, preserves first column length, and improves thumb opposition and pinch strength compared to trapeziectomy.
- Anatomical stem adaptation, similar to total hip arthroplasty, suggests a better long-term prognosis for this new prosthesis design.