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Trapeziometacarpal prosthesis: an updated systematic review
S Remy1, C Detrembleur2, X Libouton3
1Cliniques Universitaires Saint-Luc, Service d'Orthopédie et de Traumatologie de l'Appareil Locomoteur, Avenue Hippocrate 10, 1200 Brussels, Belgium.
Hand Surgery & Rehabilitation
|August 30, 2020
Summary
Trapeziometacarpal prostheses offer fast pain and function recovery for thumb osteoarthritis. However, strength gains are limited, and revision rates are high, necessitating further research.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Trapeziometacarpal (TMC) joint osteoarthritis is a common condition affecting thumb function.
- TMC prostheses are utilized in Europe, with purported benefits including length restoration, improved strength, function, and mobility, alongside reduced recovery times.
- Previous literature reviews have not consistently validated these assumed benefits.
Purpose of the Study:
- To conduct an updated systematic review and statistical analysis of TMC prostheses for thumb osteoarthritis.
- To quantify the efficacy and complication rates, specifically failure (revision) and deep infection.
Main Methods:
- A systematic literature search was performed on the Medline database using specific inclusion criteria.
- Data extraction included patient-reported outcomes (pain, function, strength) and complication rates (failure, infection).
- Statistical analysis was employed to synthesize the compiled data.
Main Results:
- Patients experienced rapid improvement in pain and function post-implantation.
- The positive impact on thumb strength appeared limited.
- The study identified a high failure rate (revision rate) but a low deep infection rate.
Conclusions:
- While TMC prostheses facilitate quick pain and functional recovery, their effect on strength is questionable.
- High revision rates indicate significant long-term concerns.
- Further randomized controlled trials are essential to reliably compare TMC prostheses with alternative surgical treatments for thumb osteoarthritis.
