[Tendon interposition arthroplasty vs Kessler silicone prosthesis for basal joint arthritis of the thumb]

Of 86 patients with osteoarthrosis of the trapeziometacarpal or pantrapezial joint operated on during 1978-1988, 52 cases (14 males, 38 females) were reviewed. 32 had undergone interposition of the flexor carpi radialis tendon and 18 Kessler's silicone prosthesis technique. 2 had silicone prosthesis replacement in 1 hand and tendon interposition in the other. The average age of all patients was 65.5 years (range 56-74). Average follow-up was 7.0 years for the 32 after the interposition procedure (range 8-14), and 10.5 years (range 8-14) after prosthesis implantation. A greater proportion of those after tendon interposition reported alleviation of pain. There was no statistically significant difference between the groups with regard to patient satisfaction, need for job change, range of abduction and opposition, grip and pinch power, thumb length and ability in activities of daily living. Tendon interposition arthroplasty is simple and relatively inexpensive compared to silicone prosthesis insertion, which has inherent complications, such as breakage of the prosthesis and synovitis. Tendon interposition has therefore been our standard procedure since 1988.