Trapezio-metacarpal arthroplasty by total prosthesis.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Rheumatology

Background:

• Trapezio-metacarpal (TMC) joint prostheses have been utilized since 1971.
• Indications for TMC arthroplasty include rheumatoid arthritis, osteoarthritis, and trauma.
• Common presenting symptoms are pain, mechanical instability, and stiffness.

Purpose of the Study:

• To evaluate the long-term outcomes of TMC prostheses.
• To identify factors influencing the success of TMC joint replacement.

Main Methods:

• A retrospective review of 34 TMC prostheses implanted since 1971.
• Follow-up data available for 28 prostheses, ranging from six months to five years.
• Analysis of outcomes based on indication (pain, instability, stiffness) and complications.

Main Results:

• Overall good results were achieved in two out of three cases.
• The best outcomes were observed for pain relief and improved joint stability.
• Stiffness as an indication yielded less satisfactory results.
• Five cases of trapezial cup loosening were attributed to operative errors.

Conclusions:

• TMC prostheses can provide effective pain relief and stability.
• Suboptimal results are often linked to incomplete treatment of associated lesions.
• Improved outcomes necessitate stricter adherence to surgical indications and meticulous operative technique.