gms | German Medical Science

Objectives: Trapeziometacarpal (TMC) total joint replacement is increasingly being performed in Europe. MAÏA TMC total joint arthroplasty is a modular uncemented ball-and-socket hydroxyapatite-coated implant. This study assessed the midterm clinical and radiological results of the MAÏA TMC prosthesis.

Method: This single-center retrospective study involved 80 patients who underwent 96 MAÏA TMC prosthesis implantations from February 2006 to April 2009, and who had a minimum of 5 years' follow-up. Indications for the procedure were painful TMC joint osteoarthritis affecting activities of daily living and a failure of at least 6 months of nonsurgical treatment. Pre- and postoperative clinical and radiographic data were reviewed.

Results: The mean age at surgery was 68 years (range, 53e84 years) and the median follow-up was 76 months (range, 60e102 months). The mean Quick Disabilities of the Arm, Shoulder, and Hand score improved from 61.3 17.1 to 17.5 16. The mobility of the thumb was restored to a range of motion comparable with that of the contralateral thumb. Opposition, defined by the Kapandji score, was almost normal (9.2 of 10; range, 6e10), as was the final mean key pinch and grip strength, which improved by 26% and 43%, respectively. Among the 96 implants, 4 (4.2%) were surgically revised for trapezium loosening. One dislocation was treated with closed reduction; 3 (3.1%) posttraumatic trapezium fractures were immo- bilized for 8 weeks. Among the 26 preoperative reducible z-deformities, only 5 (19.2%) were not totally corrected after surgery. The procedure success, by survival analysis over 6 years, was 93% (95% confidence interval, 87e98).

Conclusion: MAÏA TMC total joint arthroplasty may be a reliable treatment option for TMC joint osteoarthritis, with very good results for pain relief, strength, mobility, and restoration of the thumb length, providing correction of most thumb z-deformities.