Revision procedures after trapeziometacarpal surgery.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Rheumatology

Background:

• Thumb basal joint arthritis is a common condition.
• Surgical interventions are frequently employed for effective management.
• Various surgical techniques exist, each with potential complications and intolerances.

Purpose of the Study:

• To review and present different surgical solutions for thumb basal joint arthritis.
• To discuss complications associated with various surgical techniques.
• To guide the selection of optimal surgical strategies, including revision procedures.

Main Methods:

• Review of current surgical techniques for thumb basal joint arthritis.
• Analysis of complications including shortening, loosening, instability, and material intolerances (e.g., nickel allergy, silicone reactions).
• Discussion of revision strategies such as prosthetic replacement, trapeziectomy, and interposition with implants or ligament reconstruction.

Main Results:

• Prosthetic replacement is favored for loosening to preserve thumb length.
• Conversion to trapeziectomy with interposition is indicated for other cases.
• Implant or biological tissue interposition appears to be the most effective solution for failed trapeziectomy.

Conclusions:

• Careful consideration of potential complications is crucial for initial surgical technique selection.
• Revision surgery options exist for treatment failures, with specific approaches recommended based on the initial procedure.
• Interposition techniques offer promising solutions for complex revision scenarios in thumb basal joint arthritis.