Early Functional Outcomes and Complications of the First Carpometacarpal Arthroplasty: A Single-Institution Experience

Abstract

Rhizarthrosis is accompanied by decreased mobility, poor grip, and progressive pain. Surgical treatment, which involves various techniques, is the only definitive solution sparing the joint. First carpometacarpal (CMC) joint arthroplasty helps reduce the discomfort associated with rhizarthrosis and restores joint function. From 2020 to the end of March 2024, 35 arthroplasties of the first CMC joint have been performed. In this study, the implant survival was recorded at a five-year follow-up. Evaluation of functional outcomes was conducted using preoperative and postoperative Disabilities of the Arm, Shoulder, and Hand (DASH), visual analogue scale (VAS), and Kapandji scores. Two types of implants were used, and their postoperative DASH and Kapandji scores were compared. The one-year implant survival was 0.97, and the three-year implant survival was 0.86. Range of motion showed significant improvement in patients after the first CMC arthroplasty. The VAS score, which assesses pain, and the DASH score, used to subjectively assess upper extremity disability, showed similar postoperative improvement. There is no significant difference in postoperative outcomes (DASH score and Kapandji score) between the “standard” and “dual mobility” implant types when evaluating postoperative outcomes. One intraoperative and two postoperative complications were observed in this study. First CMC joint arthroplasty effectively relieves pain, improves range of motion, and enhances functional outcomes in patients with rhizarthrosis. Both implant types demonstrated similar postoperative results in terms of DASH and Kapandji scores. While the study observed a few complications, the overall results support the efficacy of first CMC joint arthroplasty as a reliable treatment option for restoring joint function and reducing pain.