Comparison between the MAIA® Implant and Trapeziectomy for Trapeziometacarpal Osteoarthritis: Outcomes at 9 Years' Follow-Up

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97–144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV

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Pyrocardan Trapeziometacarpal Joint Arthroplasty—Medium-Term Outcomes

Journal of Wrist Surgery ◽

10.1055/s-0040-1714685 ◽

2020 ◽

Vol 9 (06) ◽

pp. 509-517

Author(s):

James Logan ◽

Susan E. Peters ◽

Ruby Strauss ◽

Silvia Manzanero ◽

Gregory B. Couzens ◽

...

Keyword(s):

Case Series ◽

Postoperative Outcome ◽

Preoperative Assessment ◽

Pinch Strength ◽

Level Of Evidence ◽

Original Series ◽

Surgery Outcome ◽

Trapeziometacarpal Osteoarthritis ◽

Patient Reported

Abstract Objective Pyrocardan trapeziometacarpal interposition implant is a free intra-articular spacer composed of pyrocarbon. This biconcave resurfacing implant, both ligament and bone-stock sparing, is indicated for use in early-to-moderate stage trapeziometacarpal osteoarthritis. It was hypothesized that the postoperative outcome measures of the Pyrocardan implant would be comparable to those seen with ligament reconstruction and tendon interposition (LRTI) surgeries and those reported by the designer of the implant, Phillipe Bellemère, but that strength would be greater than for LRTI. Methods In this prospective case series, 40 Pyrocardan implants were performed in 37 patients. Average age was 58 years (range: 46–71). Patients were assessed preoperatively, 3 months, 6 months, 1 year, 2 years, and beyond (long term) wherever possible. Results There have been no major complications or revision surgeries for the series. Average follow-up was 29 months (range: 12 months–7 years). Twenty-eight joints were assessed at over 2 years post index surgery. Outcome measure scores improved from preoperative assessment to the most recent follow-up equal or greater than 2 years. Average grip strength at 2 years was 30 kg, as compared with 19.6 kg in an age-matched cohort who underwent trapeziectomy and 25 kg in Bellemère's original series of Pyrocardan implants. Conclusions Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis. Patient-reported clinical outcomes were at least equivalent to LRTI and are comparable to Bellemère's original series. Grip and pinch strength appear to be better than LRTI. Level of Evidence This is a Level III, prospective observational cohort study.

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Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420909198 ◽

2020 ◽

Vol 45 (5) ◽

pp. 465-469 ◽

Cited By ~ 3

Author(s):

Raphaëlle Dumartinet-Gibaud ◽

Nicolas Bigorre ◽

Guy Raimbeau ◽

Jérome Jeudy ◽

Yann Saint Cast

Keyword(s):

Survival Rate ◽

First Year ◽

Implant Survival ◽

Level Of Evidence ◽

Technical Errors ◽

Lack Of Information ◽

Trapeziometacarpal Osteoarthritis ◽

Long Run ◽

Lost To Follow Up

In this retrospective study, we report a series of 80 Arpe prostheses for trapeziometacarpal osteoarthritis in 63 patients. Twenty-seven prostheses (20 patients) were lost to follow-up. Twenty-one were revised, eight of them during the first year after operation. The calculated cumulated implant survival rate was 85% at 10 years but could be lower due to the lack of information on the patients lost to follow-up. The number of complications due to technical errors was high; but after we had done 30 cases, the number of early revisions decreased markedly. At follow-up, 23 of 32 thumbs were totally free of pain, and the patients were satisfied with 31 thumbs. We conclude that the implant survival declines progressively in the long run, with a survival rate of 80% after 15 years of follow-up and a further decline thereafter. We also found that this surgery was difficult to master. We advise selecting this implant for thumb trapeziometacarpal osteoarthritis with caution. Level of evidence: IV

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Commentary on: Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420913460 ◽

2020 ◽

Vol 45 (5) ◽

pp. 470-471

Author(s):

Michel E. H. Boeckstyns

Keyword(s):

Total Joint Arthroplasty ◽

Joint Arthroplasty ◽

Trapeziometacarpal Osteoarthritis

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Patient-reported outcomes after Silastic replacement of the trapezium for osteoarthritis

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193411419433 ◽

2011 ◽

Vol 37 (3) ◽

pp. 263-268 ◽

Cited By ~ 9

Author(s):

N. G. Burke ◽

J. Walsh ◽

C. J. Moran ◽

G. Cousins ◽

D. Molony ◽

...

Keyword(s):

Rank Correlation ◽

Dominant Hand ◽

Work Related ◽

Spearman’S Rank Correlation ◽

Trapeziometacarpal Osteoarthritis ◽

Patient Reported ◽

Outcome Scores ◽

And Function ◽

Mean Time

This retrospective study evaluated 69 Swanson trapezium replacements performed between 1990 and 2009 for trapeziometacarpal osteoarthritis in 58 patients. Pain and function were assessed using the Michigan Hand Questionnaire and the Disability of the Arm, Shoulder and Hand questionnaire. Patients had a mean age of 62 years at the time of surgery, with a mean time of 7.7 years (range 9 months to 19 years) from surgery to follow-up interview. There was no association between outcome scores and the length of follow-up, suggesting that the results are maintained over time (Spearman’s rank correlation test < ±0.2). Scores for activities of daily living and work-related activities were higher when surgery was on the dominant hand ( p < 0.05). Silicone trapezium replacement remains a good option for patients with painful trapeziometacarpal osteoarthritis that has not responded to nonoperative management.

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Elektra prosthesis for trapeziometacarpal osteoarthritis: a follow-up of 39 consecutive cases

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412443501 ◽

2012 ◽

Vol 37 (7) ◽

pp. 605-609 ◽

Cited By ~ 49

Author(s):

A. Klahn ◽

M. Nygaard ◽

R. Gvozdenovic ◽

M. E. H. Boeckstyns

Keyword(s):

Rheumatoid Arthritis ◽

Visual Analogue Scale ◽

Analogue Scale ◽

Revision Rate ◽

Gradual Increase ◽

Biomechanical Properties ◽

Fast Recovery ◽

Trapeziometacarpal Osteoarthritis ◽

The Mean

We present a prospective follow-up of 39 Elektra prostheses in 37 patients (32 women and five men), with a mean age of 56.5 (range 46–71) years; 34 patients had osteoarthritis and three had rheumatoid arthritis. Patients were followed using clinical examination, including measurement of pain on a visual analogue scale, mobility, and strength, after 6, 12, 26, and 52 weeks, and annually thereafter. Radiological examination was done preoperatively and after 6, 26, and 52 weeks, and annually thereafter. The mean follow-up time was 48 (range 3–91) months. Although we observed a fast recovery, including maintenance of mobility and a gradual increase in grip strength, there was a revision rate of 7/38 (24%) after 36 months, increasing to 17/38 (44%) after 72 months. The main reason for revision was loosening of the trapezial component, and biomechanical properties of the trapezial fixation may be the key problem in treating trapeziometacarpal osteoarthritis using a total prosthesis.

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Long-Term Results of Joint Arthroplasty with Total Prosthesis for Trapeziometacarpal Osteoarthritis in Patients over 65 Years of Age

Geriatrics ◽

10.3390/geriatrics6030065 ◽

2021 ◽

Vol 6 (3) ◽

pp. 65

Author(s):

Miguel Angel Martin-Ferrero ◽

Jose Maria Trigueros-Larrea ◽

Elsa Martin-de la Cal ◽

Begoña Coco-Martin ◽

Clarisa Simon-Perez

Keyword(s):

Long Term Results ◽

Joint Involvement ◽

Kaplan Meier ◽

Trapeziometacarpal Osteoarthritis ◽

Prevalent Disease ◽

Patient Selection Criteria ◽

Clinical And Radiological Results ◽

Surgical Treatments ◽

Joint Arthroplasties

Trapeziometacarpal osteoarthritis (TMCOA) is a highly prevalent disease in the older population. Many different types of surgical treatments are possible, depending on the degree of joint involvement, the personal and professional circumstances of the patient and the preferences of the orthopedic surgeon. This paper evaluated the clinical and radiological results of consecutive cohorts of patients over 65 years old treated with total joint arthroplasties (TJA) of the ball and socket type (B&S) for TMCOA, with a minimum of 10 years follow-up. The survival rate (Kaplan–Meier) of the functional prostheses at 10 years was 92.2% (95% CI (89.1%, 96.1%). These functional arthroplasty patients, after 10 years of follow-up, showed little or no pain, good function and good key pinch, without radiological alterations. TJAs of the B&S type are a long lasting, effective and reliable alternative to surgical treatment of TMCOA in patients over 65 years of age, when they are performed with the patient selection criteria and surgical technique described throughout this study.

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TRAPEZIECTOMY WITH LIGAMENT RECONSTRUCTION AND TENDON INTERPOSITION: A MINIMUM 10-YEAR FOLLOW-UP

Hand Surgery ◽

10.1142/s0218810413500408 ◽

2013 ◽

Vol 18 (03) ◽

pp. 365-368 ◽

Cited By ~ 11

Author(s):

Toby Vinycomb ◽

John Crock

Keyword(s):

Revision Surgery ◽

Ligament Reconstruction ◽

Long Term Outcomes ◽

Participant Satisfaction ◽

Trapeziometacarpal Osteoarthritis ◽

Alternative Techniques ◽

Objective Outcomes ◽

Tendon Interposition

Purpose: To investigate the long-term (> 10 yrs) outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI). Methods: We reviewed 15 cases of trapeziectomy with LRTI performed for the treatment trapeziometacarpal osteoarthritis. Mean follow up was 13.5 yrs (range, 10.5–17.5 yrs). We assessed a number of subjective and objective outcomes. A good outcome was a participant who did not require revision surgery, was satisfied with the outcome of their surgery and did not experience rest pain. Results: No patients had revision surgery and only two patients were unsatisfied or very unsatisfied with the outcome of their surgery. Pain with activity was the strongest predictor of participant satisfaction. Discussion: Approximately half the participants in this study experienced good long-term outcomes. Some participants were experiencing long-term symptoms, particularly pain, despite reporting that they are satisfied with the outcome of their surgery. Alternative techniques should be investigated that provide superior long-term outcomes.

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