Trapeziometacarpal Joint Arthroplasty: Medium-Term Clinical Outcomes and Survival

Trapeziometacarpal joint (TMC) arthroplasty (TMA) is a treatment option for failed symptomatic treatment of basal thumb arthritis. This study aimed to evaluate clinical and radiological outcomes and complications of Maïa™ prosthesis (Groupe Lépine, Genay, France) since its introduction in our institution with a minimum of three years follow-up. We performed a retrospective study of patients with TMA treated with Maïa prosthesis. Between 2015 and 2017, 22 patients (21 female and one male patient) were submitted to TMA with Maïa prosthesis, with a mean age of 60.1±6.6 (95%CI 57.1, 63.0) years old. According to the Eaton-Littler classification, four patients had rhizarthrosis grade II, and 18 had grade III. The average follow-up was 56.4±6.0 months (95%CI 53.8, 59.1). Mean TMC radial abduction was 53.0±15.9º (95%CI 43.1, 62.3), corresponding to 89% (95%CI 78, 100) of the contralateral side. The mean Kapandji score was 9.5±0.7 (95%CI 9.1, 9.8), corresponding to 98% (95%CI 94,100) of the opposite side. The mean key pinch was 4.7±1.4 kg (95%CI 3.9,5.4), and the mean grip strength was 8 kg (95%CI 4, 12) against 10 kg (95%CI 6, 14), which corresponded to 79% (95%CI 70, 88), and 81% (95%CI 66, 96) of the non-operated side force, respectively. The mean satisfaction score with the procedure was 8.8±2.3 (95%CI 7.6, 10.0) out of 10. The mean qDASH (Quick Disabilities of the Arm, Shoulder, and Hand) score was 25.8±30.0 (95%CI 10.0, 40.7). The total revision rate was 13.6% (two cases of dislocation and one for loosening of the trapezium cup). There were no infections. The survival rate of the implant was 86.4% (95%CI 78.3, 93.3) after a five-year follow-up. There is still limited information regarding the long-term results of TMA using the Maïa prosthesis. TMA is a technically demanding procedure with a significant learning curve. With this study, we report satisfactory medium-term results in terms of motion, strength, and patient satisfaction.