Trapeziometacarpal prostheses

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Hand surgery

Background:

• The trapeziometacarpal (TMC) joint is crucial for thumb function.
• Thumb basal joint arthritis significantly impacts quality of life.
• Historically, trapeziectomy and silastic spacers were primary treatments.

Purpose of the Study:

• To review the evolution of TMC joint prostheses.
• To evaluate the efficacy of TMC arthroplasty compared to trapeziectomy.
• To assess implant survival rates and functional outcomes.

Main Methods:

• Historical review of TMC joint prosthesis development (cemented, cementless, dual mobility).
• Analysis of implant survival rates and functional outcomes (pain relief, strength, mobility).
• Comparison of TMC arthroplasty with trapeziectomy for thumb basal joint arthritis.

Main Results:

• First-generation cemented prostheses (1970-1990) were followed by cementless designs (1990-2010).
• Third-generation dual mobility prostheses emerged after 2010.
• Current TMC arthroplasty demonstrates a 90% implant survival rate at 10 years, restoring function and correcting deformities.

Conclusions:

• TMC arthroplasty is a reliable surgical option for thumb basal joint arthritis.
• It offers comparable or superior outcomes to trapeziectomy, including improved thumb length and Z-deformity correction.
• Revision surgery with trapeziectomy after failed TMC arthroplasty yields equivalent results to primary trapeziectomy.