Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2007
[Resurfacing prosthesis for osteoarthritis of the trapeziometacarpal joint: 4.5 year follow-up in 83 implants].
The aim of this study was to present our experience with hemiarthroplasty of the base of the first metacarpal for the treatment of degenerative disease of the trapeziometacarpal joint. We have used this resurfacing implant since 1995 as part of our therapeutic armamentarium together with trapeziectomy, arthrodesis and total arthroplasty. ⋯ This hemiarthroplasty has provided satisfactory results in terms of pain relief, joint motion, and function. There has not been any long-term radiographic problem. If revision is needed for failure, the procedure is simple and trapeziectomy, total arthroplasty or arthrodesis can be performed. The hemi-implant can be inserted after total arthroplasty. Compared with other techniques, this implant avoids the problem of silicone tolerance with the Swanson implant and has provided results superior to those of arthrodesis and trapiezectomy but slightly less satisfactory than with total arthroplasty. The indication for use of this resurfacing implant is osteoarthritis of a centered trapeziometacarpal in the young subject. The implant is contraindicated for advanced-stage disease, stiff joint with retraction of the first commissure and hyperextension of the metacarpophalangeal joint.