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A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
Five-to-8-year prospective follow-up of 61 Touch® trapeziometacarpal prostheses
Cyril Falaise1, Sandrine Boulat1
1Hopital du Gier, Rue Victor Hugo, 42400 Saint-Chamond, France.
Objective:
The purpose of this study was to evaluate the clinical and radiologic outcomes of the first patients who received a dual-mobility trapeziometacarpal prosthesis in our centre, for first carpometacarpal joint osteoarthritis, with a minimum 5-year follow-up.
Patients And Methods:
Fifty-seven patients received a total trapeziometacarpal ball-and-socket arthroplasty with the Touch® prosthesis for severe arthritis and one for significant laxity. Four patients underwent bilateral surgery. One was lost of follow-up and three died during the study. Function was assessed before surgery and at one, 3, 5 and 10-years follow-up visits. Visual analog scale for pain, active thumb range of motion, including Kapandji's score, key-pinch grip strength and patients' satisfaction outcomes were recorded by an independent observer. Standardized radiographs were obtained to assess osteolysis, loosening, and subsidence.
Results:
Patients were followed for an average of 6.5 years (5-8.8). Pain decreased from 7.3 to 0.4, range of motion increased, and key grip strength improved from 67% to 102% of the contralateral side. Metacarpophalangeal hyperextension was present in 26 thumbs (46%) before surgery (5 severe, more than 30°), and in 19 thumbs (33%) at follow-up. Z-deformity was reported in 13 cases (23%) preoperatively and in 2 cases (4%) postoperatively. At maximum follow-up, radiographs showed minor osteolysis in 4 cases (7%) around the trapezium component and in 7 cases (12%) around the metacarpal component. One revision (2%) was required for cup loosening 7 years after surgery. All patients were satisfied or very satisfied with the treatment.
Conclusions:
This prospective study of 61 Touch® dual mobility prostheses confirms that this implant is a safe and effective treatment option for trapeziometacarpal osteoarthritis in the short and medium term. Continued follow-up is necessary to assess the long-term outcomes of this arthroplasty.
Level Of Evidence:
II.

