Prosthetic Joint Infections in Trapeziometacarpal Arthroplasty: A Comprehensive Systematic Review

Background: Osteoarthritisof the first trapeziometacarpal (TMC) joint (rhizarthrosis) is a degenerative condition causing pain, reduced mobility, and functional limitations, particularly in older adults and postmenopausal women. Though conservative treatments offer symptomatic relief, advanced cases often require trapeziectomy or total joint replacement. The choice of prosthesis is tailored to patient-specific factors such as age, functional demands, and comorbidities. Despite the benefits of TMC joint replacements, prosthetic infections remain underexplored. Materials and Methods: This systematic review (covering 2000-2024) adhered to PRISMA guidelines, searching Medline, Cochrane, and Google Scholar for randomized controlled trials and case series. Data on demographics, prosthesis types, infection rates, and management strategies were extracted and analyzed. Results: Among 4165 TMC joint procedures reported in 63 studies, 15 cases (0.36%) involved superficial or deep infections, with Staphylococcus aureus identified in two instances. Management ranged from antibiotic therapy and debridement to prosthesis removal with or without reimplantation. Conclusions: Variability in diagnostic criteria and reporting limited uniform conclusions. Although infections are infrequent, they pose significant management challenges due to inconsistent diagnostic criteria and treatments. Early identification and tailored interventions remain critical. This review underscores the need for standardized protocols and highlights gaps in current research. Future studies should focus on multicenter trials and robust methodologies to improve outcomes and advance infection management in TMC prosthesis surgery.