Arthroplasty in Thumb (CMC Joint) Osteoarthritis: Avoiding Trapeziectomy

To show the postoperative clinical results, including the patient-reported time to return to the activities of daily living (ADLs), the radiographic aspects, and the grip strength of total joint arthroplasty in patients with stage-III rizarthrosis.

In the present single-center and prospective study, we analyzed total joint arthroplasty with an uncemented, metal-on-polyethylene prosthesis (Maia, Groupe Lepine). The inclusion criteria were patients with stage-III carpometacarpal (CMC) joint osteoarthritis, aged > 60 years, initially treated through non-surgical procedures. The exclusion criteria were patients presenting mental illness, alcohol abuse, rheumatological arthritis.

During the study period (from January 2018-October 2023), 34 patients met the patient selection criteria. Three eligible patients received a different implant, and two were simultaneously submitted to surgery in another joint (metacarpophalangeal joint with Z-deformity); these subjects were not included in the study. After 25.1 months of the surgery, grip strength was of 87.75% regarding the opposite side, the scores on the Visual Analogue Scale (VAS) and on the short form of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire were of 1, and the range of motion was of 81% compared to the unaffected side. On the X-ray examination, initial metacarpal subsidence was observed in 100% of the patients. Complications were observed in 2 (6.9%) patients.

The choice of total joint arthroplasty to treat active patients aged > 60 years with stage-III CMC joint arthritis preserves independence to perform ADLs and improves quality of life in the first 12 months of the procedure.