アジア人集団におけるTouch®プロテーゼを用いた舟状甲基関節形成術：後向き研究

Trapeziometacarpal joint (TMJ) arthroplasty is an increasingly popular option in the management of TMJ arthritis. The Touch^® prosthesis is a fourth-generation implant used primarily in Europe with good mid-term outcomes. As the first country in Asia to offer the Touch^® prosthesis since it became availabile in 2020, the purpose of this study was to evaluate the clinical outcomes of our patients who underwent TMJ arthroplasty in an Asian population and context.

Patients who underwent TMJ arthroplasty with Touch^® prosthesis between August 2020 and September 2024 were eligible. Clinical outcomes included pain improvement, range of motion, strength, occupational status, Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), EQ-5D-5L and general satisfaction.

Forty-two patients were treated, with 46 TMJ arthroplasties, of whom 38 patients with 41 TMJ arthroplasties were included in the study. There were four major complications, including two cases of implant loss. Pain score improved significantly from 7 (IQR 5.5 to 8) to 0 (IQR 0 to 0) at the latest follow-up. All patients returned to their original occupations at a mean of 5 (IQR 3 to 8) weeks. The post-operative QuickDASH score was 4.5 (IQR 0 to 9.1) and the EQ-5D-5L index was 1 (IQR 0.908 to 1). Of note, 40 out of the 41 cases used the 9 mm cup and the majority (32 implants) used the smaller size stems (XS and T0). One procedure had to be abandoned as the trapezium surface area was too narrow.

Arthroplasty using the Touch^® prosthesis is a safe and effective procedure to treat TMJ osteoarthritis in the Asian population with good clinical outcomes. Care should be taken with patient selection and surgical procedure in view of the smaller trapezium sizes in Asian patients. Future research should include the design of smaller implant sizes for this unique population.

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