MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 80 Patients With More than 6 Years of Follow-Up

Toffoli, Adriano; Teissier, Jacques

doi:10.1016/j.jhsa.2017.06.008

Cited by 71 publications

(69 citation statements)

References 48 publications

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“…Periprosthetic lucency of the implant was more than 1 mm in seven cases, but did not correlate with frank implant loosening or failure with a minimum of 2 years follow-up, which is consistent with observations by Barrera-Ochoa et al[10]. Recent studies of the trapeziometacarpal joint arthroplasty have reported 89% to 95% of survival rate at 5 years from the operation, and revision rate was 0% to 11.5%[30, 31]. The long-term comparative analysis should be required to determine which arthroplasty implant and surgical treatment have superior durability and failure rate.…”

Section: Discussionsupporting

confidence: 86%

Tendon versus Pyrocarbon Interpositional Arthroplasty in the Treatment of Trapeziometacarpal Osteoarthritis

Chun

Koh

et al. 2019

BioMed Research International

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Background. Trapeziometacarpal (TMC) arthritis is treated with surgery when nonsurgical treatment fails. The best surgical option for improving pain relief, functional outcomes, and postoperative complications remains controversial. The purpose of this study was to compare clinical and radiological outcomes and complications between trapezium excision with ligament reconstruction and tendon interposition (LRTI) and pyrolytic carbon interpositional arthroplasty. Methods. From March 2009 to August 2014, 37 patients (39 wrists) with Eaton-Littler stage II or III TMC arthritis underwent complete trapezium excision with LRTI (Group L, n=19) or pyrolytic interpositional arthroplasty (Group P, n=20). Visual analog scale (VAS) pain scores; grip and pinch strength; Kapandji scores to quantify thumb opposition; and Disabilities of Arm, Shoulder, and Hand (DASH) scores were used to compare clinical outcomes between the two groups. Radiographic changes (metacarpal shortening, subluxation, and radiolucency) were evaluated on the radiographs of thumb basal joints. Results. There were no differences in patient demographics, Eaton-Littler stage, preoperative outcome measures, or the duration of follow-up between the two groups. At the last follow-up, VAS pain scores, pinch and grip strengths, Kapandji scores, and DASH scores were significantly improved in both groups compared with preoperative scores. All follow-up measurements were similar between the two groups except pinch strength, which was 1.8 kg higher in Group P (p<0.001). Proximal metacarpal migration did not differ significantly between the groups. Periprosthetic lucency more than 1 mm was observed in 7 of 20 (35%) thumbs. Complication rates were similar between the two groups. Conclusions. All subjective and objective outcomes were similar following LRTI and pyrolytic interpositional arthroplasty in patients with TMC arthritis, except pinch strength, which was more improved following pyrolytic interpositional arthroplasty. Longer follow-up is required to test adverse effects of high rates of periprosthetic lucency and prosthetic subluxation on clinical outcomes after PyroDisk interpositional arthroplasty.

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Section: Discussionsupporting

confidence: 86%

Tendon versus Pyrocarbon Interpositional Arthroplasty in the Treatment of Trapeziometacarpal Osteoarthritis

Chun

Koh

et al. 2019

BioMed Research International

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“…A number of studies reporting low implant failure rates in none metal-on-metal type prostheses support our hypothesis. The Arpe® system and Maia® system show revision rates of 5%–9% and 4%–11%, respectively; both prostheses use a metal-on-polyethylene bearing (Bricout and Rezzouk, 2016; Cootjans et al., 2017; Robles-Molina et al., 2017; Toffoli and Teissier, 2017).…”

Section: Discussionmentioning

confidence: 99%

Elektra prosthesis versus resection-suspension arthroplasty for thumb carpometacarpal osteoarthritis: a long-term cohort study

Froschauer

Holzbauer

Hager³

et al. 2019

J Hand Surg Eur Vol

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The present study compares 34 patients with thumb carpometacarpal osteoarthritis (37 thumbs) treated with the Elektra® prosthesis, with 18 patients (18 thumbs) treated with resection-suspension arthroplasty, with an overall mean follow-up period of 13.3 years. Evaluation with disability of arm and shoulder scores, pain via visual analogue scale and range of motion (radial and palmar abduction, and opposition) indicated no significant difference. However, the cohort with a surviving prosthesis showed significantly better subjective grip strength ( p = 0.04). Complications occurred in 23 of the 37 thumbs in the prosthesis group compared with two in the resection-suspension arthroplasty patients. Seventeen prostheses required revision. At revision operations, we observed local signs of metallosis in 15 of 17 cases. The patients receiving resection-suspension arthroplasty were more satisfied with their treatment ( p = 0.003). Therefore, we cannot recommend the implantation of Elektra® prosthesis and we speculate that the key problem of aseptic cup loosening is a result of the metal-on-metal bearing. Level of evidence: III

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“…This phenomenon could in vivo correspond to an overstress of prosthetic elements. This penetration supports the fact that the most frequent prosthesis revision is due to the loosening of the trapezium cup [11,36]. Chakrabarti et al [36] showed that 91% of prosthesis revisions are due to loosening of the cup.…”

Section: Resultsmentioning

confidence: 54%

“…However, there are also many reports of poor results [10]. Revisions are most often due to the loosening of the trapezium cup [11,12] and of the metacarpal stem and to the luxation of the first metacarpal bone [13] (Figure 3).…”

Section: Introductionmentioning

confidence: 99%

Trapeziometacarpal Joint: A Mechanical Explanation of Total Prosthesis Failures

Spartacus¹

2019

Biomechanics

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Total prosthesis, which preserves strength and respects trapeziometacarpal (TMC) joint range of motion, is a surgical option considered for the TMC joint replacement. With the usual ball-and-socket design, patients obtain faster pain relief, stronger grip function, and shorter convalescence than with trapeziectomy. However, prostheses currently used have led to various early complications, especially in active and young patients. Revisions are most often due to the loosening of the trapezium cup and of the metacarpal stem and to the luxation of the first metacarpal bone. The short lifespan of these devices suggests the difficulty of designing a prosthesis that respects the complex anatomy and motions of the TMC joint. Early implant failure may reflect the fact that the current devices do not exactly replicate the true kinematics. The aim of this chapter will be to shed light mechanical explanations for TMC prosthesis failures in regard to the complex kinematics of the joint.

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MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 80 Patients With More than 6 Years of Follow-Up

Cited by 71 publications

References 48 publications

Tendon versus Pyrocarbon Interpositional Arthroplasty in the Treatment of Trapeziometacarpal Osteoarthritis

Tendon versus Pyrocarbon Interpositional Arthroplasty in the Treatment of Trapeziometacarpal Osteoarthritis

Elektra prosthesis versus resection-suspension arthroplasty for thumb carpometacarpal osteoarthritis: a long-term cohort study

Trapeziometacarpal Joint: A Mechanical Explanation of Total Prosthesis Failures

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