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Surgery for Trapeziometacarpal Joint Arthritis: A Network Meta-Analysis of Randomized Studies
Dimitris Challoumas1,2, Ali Hamad3, Varun Rana4
1Institute of Infection and Immunity, University of Glasgow, Glasgow, UK.
Journal of Hand Surgery Global Online
|June 11, 2025
Summary
Total joint arthroplasty shows similar short-term pain relief and functional improvement compared to trapeziectomy for TMCJ arthritis. However, it may offer superior key pinch strength, though long-term data are needed for definitive recommendations.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biostatistics
Background:
- Trapeziometacarpal joint (TMCJ) arthritis is a common condition causing pain and functional limitation.
- Various surgical interventions exist, but comparative efficacy and safety data are crucial for clinical decision-making.
Purpose of the Study:
- To systematically review and perform a network meta-analysis comparing surgical treatments for TMCJ arthritis.
- To evaluate patient-reported pain, functional disability, key pinch strength, and complication rates.
Main Methods:
- Systematic review and network meta-analysis of 21 randomized controlled trials.
- Primary outcome: patient-reported pain. Secondary outcomes: functional disability, key pinch strength, complications.
- Calculated mean differences (MD), standardized mean differences (SMD), and odds ratios (OR) with 95% confidence intervals.
Main Results:
- Total joint arthroplasty demonstrated similar short-term pain relief and functional disability improvement compared to trapeziectomy (with or without LRTI).
- Total joint arthroplasty showed statistically significant superiority in short-term key pinch strength over trapeziectomy.
- Short-term complication rates were similar between compared interventions; long-term data remain unavailable.
Conclusions:
- Total joint arthroplasty appears comparable to trapeziectomy for short-term pain and function in TMCJ arthritis.
- While potentially superior for key pinch strength, widespread adoption requires long-term efficacy and safety data from high-quality comparative studies.
