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[Revision surgery after trapeziometacarpal joint arthroplasty]
Victoria Franziska Struckmann1, Thomas Krohn2, Ali Ayache3
1BG Klinik Ludwigshafen, Klinik für Handchirurgie, Plastische und Rekonstruktive Chirurgie, Verbrennungszentrum, Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland. victoria.struckmann@bgu-ludwigshafen.de.
Objective:
Restoration of pain-free mobility of the trapeziometacarpal joint (TMJ) after a complicated course following arthoplasty through revision surgery with preservation of the prosthesis.
Indications:
Complications during or after implantation of a thumb carpometacarpal joint endoprosthesis, such as first metacarpal shaft fracture, cup malalignment, cup loosening, trapezium fracture, and impingement.
Contraindications:
Insufficient bone stock and/or the presence of infection may argue against revision surgery with preservation of the prosthesis.
Surgical Technique:
Various techniques are employed depending on the indication for revision, as outlined below.
Postoperative Management:
As with the primary operation, revision of the neck component usually requires only a short period of immobilization. Revision of the cup or stem may require a longer period of immobilization of up to 6 weeks, depending on the extent of the revision.
Results:
In our cohort, the postoperative outcome following the described revision procedures was comparable to that after primary thumb carpometacarpal arthroplasty without subsequent revision, with observed differences largely attributable to prolonged immobilization necessitated by revision of the components implanted in the bone.
