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Related Experiment Video

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Thumb CMCJ prosthetic total joint replacement: a systematic review.

Thomas J Holme1, Marta Karbowiak2, Jennifer Clements1

  • 1Epsom & St Helier University Hospitals NHS Trust, Trauma & Orthopaedics, Carshalton, UK.

EFORT Open Reviews
|June 21, 2021
PubMed
Summary

Thumb carpometacarpal joint (CMCJ) prosthetic replacement improves pain and function, with increasing study quality. While modern implants show lower failure rates, further research is needed for optimal outcomes.

Keywords:
CMCJTMCJarthroplastyreplacementthumb

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Thumb carpometacarpal joint (CMCJ) arthritis is a prevalent and debilitating condition.
  • Prosthetic replacement is a surgical option to restore thumb biomechanics, alleviate pain, and enhance function.
  • Previous reviews highlighted a scarcity of high-quality evidence, necessitating an updated assessment.

Purpose of the Study:

  • To systematically review and synthesize the current evidence on thumb CMCJ prosthetic total joint replacement outcomes.
  • To evaluate patient-reported outcome measures (PROMs), pain, range of motion, strength, survival rates, and complications.
  • To compare prosthetic replacement with alternative treatments like resection arthroplasty.

Main Methods:

  • A systematic literature review was performed adhering to PRISMA guidelines.
  • Databases were searched for studies evaluating thumb CMCJ prosthetic total joint replacement outcomes.
  • Data extraction included PROMs, pain scores, range of motion, strength, survival rates, and complications from 56 eligible studies (2731 patients, 3048 replacements).

Main Results:

  • Overall, thumb CMCJ prosthetic replacement demonstrated significant improvements in PROMs, pain scores, and strength.
  • Implant failure rates varied from 2.6% to 19.9% depending on the specific implant.
  • Comparative studies indicated that prosthetic replacement yielded modest PROMs improvements over resection arthroplasty but with increased complication rates.

Conclusions:

  • The number and quality of studies on thumb CMCJ prosthetic total joint replacement are increasing.
  • Implant loosening and dislocation remain concerns, though appear reduced with modern implants compared to older designs.
  • While functional outcomes are promising compared to resection arthroplasty, further high-quality research with standardized techniques and outcomes is recommended.