gms | German Medical Science

Objectives/Interrogation: Assess the functional and radiological results of thumb CMC joint replacement done at Tygerberg Hospital

Methods: Patients who had one side of CMC joint surgery done at our institution 1-2 years back and now presented with CMC arthritis (Eaton Stage III disease) to the other hand and booked for thumb CMC joint excision arthroplasty were enrolled in this case series.

CMC thumb replacement was done with the same approach as the tightrope procedure, dorsolateral approach between APL and EPB, capsular release was also kept the same way for later repair. Joint replacement was done with un-cemented stem to the metacarpal after preparation of the trapezium the cup was inserted and bipolar head was used for articulation. Capsular repair was performed and thumb spica back slab was applied for two weeks. At follow-up short splint was given for two weeks and mobilization was started.

The patients were follow up at 6 weeks, 3 months, 6 months and one year. The radiological parameters like implant position and height was checked and compared cmc tightrope group as well as the functional outcomes by means of DASH score.

Results: We currently have done 10 patients with CMC implant arthroplasty and at six months post-surgery radiological results shows good position of components with no dislocations.

Functional results of CMC arthroplasty group at six months are the same as in CMC tightrope group with better pinch grip strength.

Conclusion: CMC implant arthroplasty is less painful as compared to the resection arthroplasty, has earlier return to function, better range of movements and pinch strength almost double the CMC excision arthroplasty site at six months.