gms | German Medical Science

Objectives/Interrogation: The Arpe implant is a total joint prosthesis to treat trapeziometacarpal osteoarthritis. Good survival rates have been reported at 5 years, but not many studies reported results at ten years follow-up.

Methods: Fifty patients with 66 Arpe prostheses were included in the study. Mean follow-up was ten years. It was noted if implants had been removed or revised. The Kaplan-Meier method was used to calculate survival analysis. Patients were evaluated with the disability of arm, shoulder and hand (DASH) and scores from 0 to 10 for pain, satisfaction and willingness to have the same operation again.

Results and Conclusions: At ten year follow-up, 7 out of 66 implants were explanted and revised with tendon interposition. The cup (with or without the neck) was replaced in 3 patients and only the neck was revised in 2. Ten-year survival was 87% when failure was defined as implant removal followed by trapeziectomy and tendon interposition. Ten-year survival was 82% when revision of the cup was also considered as failure and it was 80% when replacement of the neck alone was also considered as an endpoint. Of the 52 prostheses that were not revised mean DASH score was 11, mean pain score 1.2 and mean score for satisfaction 9.5.

It can be concluded that the majority of patients who did not underwent revisions were satisfied and had little or no pain. However, long-term survival of the Arpe prosthesis was moderate and patients should be warned that after ten years the risk for reoperation might be as high as 20%.