Arthroplasty for trapeziometacarpal arthrosis

We evaluated twenty-eight patients (30 thumbs) after ligament reconstruction arthroplasty for trapeziometacarpal arthrosis. The mean age was 60 years, 86% were women, and the average follow up was 38 months. Subjective results showed excellent (40%) or good (57%) pain relief in 97% of patients. Return to previous work or activity level was achieved in 98%. Overall satisfaction was observed in 86% of patients, mostly because of pain relief. Functional improvement was reported for many activities except for jar opening, which continued postoperatively to be the most difficult task to perform. Thumb mobility improved postoperatively. Key pinch strength showed an overall decrease of 27%. Proximal migration of the thumb metacarpal measured 27% and radial subluxation measured 1%. Thumb metacarpophalangeal joint hyperextension was present in > 50% preoperatively and in 7 of 30 thumbs postoperatively. Hyperextension was prevalent among women on hormone replacement therapy including three patients who had recurrence of these deformities in spite of attempts to stabilize this joint during surgery.