PURPOSE OF THE STUDY: Rhizarthrosis-osteoarthritis of the thumb carpometacarpal (CMC) joint is usually a primary idiopathic disease. Total joint arthroplasty (TJA) is one of the surgical treatment options for symptomatic advanced thumb CMC arthritis. This retrospective study aims to evaluate the mid-term functional and radiological results of TJA with the minimum follow-up period of 3 years after the surgery. MATERIAL AND METHODS: Presented are the results of 136 total trapeziometacarpal joint replacements in the group of 105 patients consisted of 96 women and 9 men. Used prostheses were ELiS® implant (27 cases), Ivory® implant (42 cases), Touch® Dual mobility (67 cases). The follow-up period was minimally 3 years postoperatively. In all the patients, along with range of motion and radiologic evaluation of implant position, the function and pain of operated joint were evaluated using DASH and VAS score at regular intervals pre- and postoperatively. RESULTS: At a mean of 85 months (range 38-126 months) post-operatively, patients in 116 cases (85%) reported full satisfaction and absence of symptoms and difficulties. In 12 cases (9%) some slight residual post-exercise pain was reported. In eight cases (6%) patients suffered from episodic rest-pain, but with a lower intensity than in the preoperative period. Postoperatively, the patients declared subjective improvement in hand function. The total DASH score and VAS score decreased in all patients, while ROM increased. The course of all of TJA surgeries was complication-free. Five patients needed revision surgery. In two patients a dislocation has occurred and in three cases a loosening of the cup's implant was reported. The most frequent postoperative complication was the occurrence of transient paraesthesias of the thumb in eight cases (6%). CONCLUSIONS: TJA is the method of choice in management of advanced symptomatic osteoarthritis of the thumb CMC joint. Mastering surgical technique, TJA represents safe and effective treatment method in advanced degenerative changes of the thumb CMC joint and it's benefits exceed possible perioperative and postoperative risks.

Department of Orthopaedic Surgery Hospital Chomutov Krajská Zdravotní a s Chomutov Czech Republic

Department of Orthopaedics and Traumatology 2nd Faculty of Medicine Charles University Prague and University Hospital Motol Prague Czech Republic

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Kapandji IA (2007) The physiology of the joints. Churchill Livingstone, Edinburg

Armstrong AL, Hunter JB, Davis TR (1994) The prevalence of degenerative arthritis of the base of the thumb in post-menopausal women. J Hand Surg Br 19:340–341 PubMed DOI

Pilný J, Jindra M, Krejzová J, Řihošková M, Bažantová K (2008) Rhizarthrosis of carpometacarpal (CMC) joint of a thumb. Cech Revmatol 3:110–113

Eaton RG, Glickel SZ (1987) Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment. Hand Clin 3:455–471 PubMed DOI

Hudak PL, Amadio PC, Bombardier C (1996) Developement of an upper extremity outcome measure: DASH (disabilities of the arm, shoulder and hand). The upper extremity Collaborative group (UECG). Am J Ind Med 29:602–608 PubMed DOI

Závodný I, Pavličný R, Holinka M (2018) Short-term results of the carpometacarpal joint arthroplasty using the Ivory prosthesis. Acta Chir Orthop Traumatol Cech 85:130–136 DOI

Froschauer SM, Holzbauer M, Mihalic JA, Kwasny O (2021) TOUCH PubMed DOI PMC

Gonzales-Espino P, Pottier M, Detrembleur CH, Goffin D (2021) TOUCH DOI

Lussiez B, Falaise C, Ledoux P (2021) Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years. J Hand Surg Eur 46:961–967 DOI

Goubau JF, Goubau L, Goorens CK, Van Hoonacker P, Kerckhove D, Vanmierlo B, Berghs B (2015) De Quervain tenosynovitis following trapeziometacarpal ball-and-socket joint replacement. J Wrist Surg 4:35–42 PubMed DOI PMC

Avisar E, Elvey M, Tzang C, Sorene E (2015) Trapeziectomy with a tendon Tie-in implant for osteoarthritis of the trapeziometacarpal joint. J Hand Surg Am 40:1292–1297 PubMed DOI

Jurča J, Havlas V (2018) Interposition and suspension arthroplasty of carpometacarpal joint of the thumb using the TIE-IN implant. Acta Chir Orthop Traumatol Cech 85:125–129 PubMed DOI

Vermeulen GM, Slijper H, Feitz R, Hovius SER, Moojen TM, Selles RW (2011) Surgical management of primary thumb carpometacarpal osteoarthritis: a systematic review. J Hand Surg Am 36:157–169 PubMed DOI

Burton RI, Pellegrini VD Jr (1986) Surgical managment of basal joint arthritis of the thumb. J. Hand Surg Am 1-A:324 DOI

Jurča J, Němejc M, Havlas V (2016) Surgical treatment for advanced rhizarthrosis. Comparison of results of the Burton–Pellegrini technique and trapeziometacarpal joint arthroplasty. Acta Chir Orthop Traumatol Cech 83:27–31 PubMed DOI

Caroll RE (1987) Arthrodesis of the carpometacarpal joint of the thumb. Clin Orthop 220:106–110

De Smet L, Van Meir N, Verhoeven N, Degreef I (2010) Is still a place for arthrodesis in the surgical treatment of basal joint osteoarthritis of the thumb? Acta Orthop Belg 76:719–724 PubMed

Chamay A (1994) Arthrodesis of the trapeziometacarpal joint. J Hand Surg 19:489–497 DOI

Pech J, Veigl D, Hromádka R, Dobiáš J, Zatrapa T (2014) Shape-memory osteosynthesis for trapeziometacarpal joint arthrodesis. Acta Chir Orthop Traumatol Cech 81:335–339 PubMed DOI

Zdráhal M (2009) Arthrodesis of carpometacarpal joint of the thumb using a cannulated screw. Acta Chir Orthop Traumatol Cech 76:326–328 PubMed DOI

De la Caffiniere JY, Aucouturier P (1979) Trapezio-metacarpal arthroplasty by total prosthesis. Hand 11:41–46 PubMed DOI

De Smet L, Sioen W, Spaepen D, Van Ransbeeck H (2004) Total joint arthroplasty for osteoarthritis of the thumb basal joint. Acta Orthop Belg 70:19–24 PubMed

Van Cappelle H, Elzenga P, Van Horn JR (1999) Long-term results and loosening analysis of de la Caffiniere replacements of the trapeziometacarpal joint. J Hand Surg Am 24:476–482 PubMed DOI

Krughaug Y, Lie SA, Havelin LI, Furnes O, Hove LM, Hallan G (2014) The results of 479 thumb carpometacarpal joint replacements reported in the Norwegian Arthroplasty Register. J Hand Surg Eur 39:819–825 DOI

Eecken SV, Vanhove W, Hollevoet N (2012) Trapeziometacarpal joint replacement with the Arpe prosthesis. Acta Orthop Belg 78:724–729 PubMed

Martin-Ferrero M (2014) Ten-year long-term results of total joint arthroplasties with ARPE implant in the treatment of trapeziometacarpal osteoarthritis. J Hand Surg Eur 39:826–832 DOI

Kubát P, Trtík L (2012) Maïa Trapeziometacarpal implant for treatment of advanced osteoarthritis of the basal joint of the thumb. Acta Chir Orthop Traumatol Cech 79:520–523 PubMed DOI

Goubau JF, Goorens CK, Van Hoonacker P, Berghs B, Kerckhove D, Scheetlinck T (2013) Clinical and radiological outcomes of the Ivory arthroplasty for trapeziometacarpal joint osteoarthritis with a minimum of 5 years of follow-up: a prospective single-centre cohort study. J Hand Surg Eur 38:866–874 DOI

Spaans AJ, Van Minnen LP, Weijns ME, Braakenburg A, Van der Molen AB (2016) Retrospective study of a series of 20 Ivory prostheses in the treatment of trapeziometacarpal osteoarthritis. J Wrist Surg 5:131–136 PubMed DOI PMC

Noyer D, Caton JH (2017) Once upon a time…. Dual mobility: history. Int Orthop (SICOT) 41:611–618 DOI

Filus D, Pavlicny R (2023) Short-term outcomes of Touch PubMed DOI

Hansen TB, Stilling M (2013) Equally good fixation of cemented and uncemented cups in total trapeziometacarpal joint protheses. A rabdomized clinical RSA study with 2-year follow up. Acta Orthop 84:98–105 PubMed DOI PMC

Kaszap B, Daecke W, Jung M (2013) Outcome comparision of primary trapeziectomy versus secondary trapeziectomy following failed total trapeziometacarpal joint replacement. J Hand Surg Am 38:863–871 PubMed DOI

Knak J, Hansen TB (2016) Trapeziectomy or revision into a cemented polyethylene cup in failed trapeziometacarpal total joint arthroplasty. J Plast Surg Hand Surg 50:286–290 PubMed DOI

Wachtl SW, Sennwald GR (1996) Non-cemented replacement of the trapeziometacarpal joint. J Bone Surg Br 78:787–792 DOI

Semerse A, Vuillerme N, Corcella D, Forli A, Moutet F (2015) Results with the Roseland DOI