Trapeziometacarpal prostheses

Hand Surg Rehabil. 2021 Sep:40S:S106-S116. doi: 10.1016/j.hansur.2020.09.013. Epub 2021 Feb 1.

Abstract

In 1970, Jean-Yves de la Caffinière developed the first trapeziometacarpal (TMC) joint prosthesis, a ball-and-socket design based on hip replacement implants. From 1970 to 1990, the first generation of cemented prostheses was developed. At that time, trapeziectomy, with tendon interposition or suspension arthroplasty, and Swanson silastic spacers remained the most widely used surgical procedures for thumb basal joint arthritis. From 1990 to 2010, a second generation of cementless prostheses was developed. The third generation was introduced after 2010 and consisted of dual mobility prostheses. In 2020, TMC arthroplasty (simple or dual mobility) is a reliable option in thumb basal joint arthritis with an implant survival rate of 90% at 10 years of follow-up, while providing pain relief and restoring strength and mobility. Restoration of the thumb's length corrects most thumb Z-deformities, so the TMC joint prosthesis may be a viable alternative surgical solution to trapeziectomy, which remains the gold standard in English-speaking countries. Moreover, trapeziectomy after failed TMC arthroplasty provides outcomes equivalent to those of primary trapeziectomy.

Keywords: Arthritis; Chirurgie; Humb; Prosthesis; Prothèse; Rhizarthrose; Surgery.

MeSH terms

  • Arthroplasty, Replacement*
  • Humans
  • Joint Prosthesis*
  • Osteoarthritis* / surgery
  • Tendons / surgery
  • Thumb / surgery