Touch thumb arthroplasty Impormasyon Pahintulot

Bakit iminungkahi ang operasyong ito

Si Dr Kieran Hirpara, isang upper-limb surgeon sa Mater Private Hospital Rockhampton, ay nagsisimula sa mga opsyon na hindi gaanong invasive na angkop sa iyong kondisyon. Ang mga pasyente ay karaniwang nirerefer sa aming klinika ng kanilang GP; kung iminungkahi ng isang physiotherapist na magpatingin sa amin, kakailanganin mo pa rin ng referral mula sa iyong GP upang maging eligible para sa Medicare rebate. Sa iyong appointment, kumukuha kami ng history, sinusuri ang iyong kamay, at nagsasaayos ng imaging kung kinakailangan upang kumpirmahin ang diagnosis.

Ang thumb base arthritis ay wear-and-tear arthritis sa joint kung saan nagtatagpo ang iyong hinlalaki at pulso. Nagdudulot ito ng sakit sa base ng hinlalaki, madalas na may pakiramdam ng pag-slip sa joint, at maaari nitong gawing mahirap ang pag-pinch at pag-grip. Ang pagpihit ng susi, pagbubukas ng pinto ng kotse, o pagpulot ng libro ay maaaring maging mahirap. Karaniwan naming sinusubukan muna ang non-operative care, gaya ng pagbabago sa aktibidad, physiotherapy o hand therapy, at splinting. Isinasaalang-alang ang surgery kapag ang mga hakbang na ito ay hindi nagbigay ng sapat na pagbuti.

Ang touch thumb arthroplasty ay nangangahulugang pagpapalit ng gasgas na thumb base joint ng isang artificial joint. Inaalok ito sa mga taong ang arthritis ay limitado lamang sa joint na iyon. Layunin ng operasyon na bawasan ang sakit at ibalik ang haba, lakas, at paggalaw ng hinlalaki. Ang implant survival para sa prosthesis na ito ay 96% sa loob ng 2 taon. Tatalakayin namin sa iyo kung ito ay angkop sa iyong kamay at sa iyong mga layunin.

Bago ang operasyon

Kapag naplano na ang operasyon, mag-aayos kami ng mga X-ray ng iyong hinlalaki at pulso upang masukat namin ang joint at maplano ang replacement. Ang ilang tao ay nangangailangan din ng MRI o ultrasound scan. Sa araw ng iyong operasyon, kakailanganin mong itigil ang pagkain at pag-inom pitong oras bago ito. Humihingi kami ng pitong oras sa halip na mas maikling oras upang maaari kang mauna kung maagang matapos ang listahan sa theatre. Sasabihin sa iyo ng iyong surgeon kung alin sa iyong mga nakasanayang gamot ang dapat itigil at kailan, kaya magdala ng nakasulat na listahan ng lahat ng iyong iniinom, kabilang ang mga tablet at supplement. Mag-ayos ng taong maghahatid sa iyo pauwi pagkatapos, dahil hindi mo kayang magmaneho nang mag-isa. Magsuot ng maluwag at komportableng damit na may mga manggas na madaling tanggalin. Kung mayroon kang iba pang kondisyong medikal, maaaring kailanganin mo ng mga blood test o review kasama ang anaesthetist bago ang araw ng operasyon.

Sa araw ng operasyon

Sa araw ng iyong operasyon, darating ka sa surgical admissions unit ng ospital. Doon ka mag-che-check in at ihahanda para sa theatre. Pagkatapos ay makikipagkita ka sa anaesthetist, ang doktor na nagbibigay ng anaesthetic at nag-aalaga sa iyo habang ikaw ay tulog.

Ang operasyong ito ay ginagawa sa ilalim ng general anaesthetic. Ikaw ay magiging tulog nang husto para sa operasyon. Ang ilang mga pasyente ay maaaring sumailalim din sa regional nerve block para sa pagpapaginhawa ng sakit pagkatapos ng operasyon; ang anaesthetist ang magpapasya sa araw na iyon batay sa iyong indibidwal na kalagayan.

Pagkatapos nito, dadalhin ka sa operating theatre, kung saan isasagawa ang operasyon. Kapag natapos na ito, magigising ka sa recovery area. Babantayan ka ng mga nurse doon habang nawawala ang bisa ng anaesthetic. Kapag stable ka na, pupunta ka sa ward o uuwi na sa bahay, depende sa procedure at kung paano ang takbo ng iyong paggaling.

Ano ang kinapapalooban ng operasyon

Ang touch thumb arthroplasty ay pinapalitan ang gasgas na joint sa base ng iyong hinlalaki ng isang artificial joint na gawa sa mga bahaging metal at plastik. Ang iyong surgeon ay gagawa ng isang hiwa sa ibabaw ng bahaging inooperahan upang marating ang joint.

Kapag narating na ang joint, tatanggalin ng iyong surgeon ang mga gasgas na surface ng joint. Ang isang bahagi ng bagong joint ay ikakabit sa buto ng iyong hinlalaki, at ang isa pang bahagi ay ilalagay sa maliit na buto ng pulso kung saan nakapatong ang hinlalaki. Ang dalawang bahagi ay gagalaw pagkatapos laban sa isa't isa gaya ng ginagawa ng isang malusog na joint. Sinisiguro ng iyong surgeon na protektado ang mga kalapit na istruktura, kabilang ang artery na dumadaan malapit sa joint at ang tendon na tumatawid dito.

Ibinabalik ng bagong joint ang haba at alignment ng iyong hinlalaki. Ang layunin ay isang hinlalaki na gumagalaw, kumukurot, at humahawak nang may mas kaunting sakit kaysa noon.

Kapag nakalagay na ang replacement, sasara ng surgeon ang hiwa gamit ang mga tahi. Lalagyan ng dressing ang sugat, at pananatilihin mo ang dressing na iyon sa loob ng humigit-kumulang 10 araw.

Pagkatapos ng operasyon

Karamihan sa mga pasyente ay nananatili ng isang gabi sa ospital pagkatapos ng operasyong ito, bagaman ang ilan ay nakakauwi sa mismong araw. Magigising ka sa recovery area, pagkatapos ay ililipat sa ward kapag stable ka na. Ang iyong kamay ay nakalagay sa isang splint na may mga dressing sa ibabaw ng sugat. Ayos lang ang bumangon at gumalaw-galaw; tutulungan ka ng mga nurse sa simula. May nakaplano nang pain relief para sa iyo bago ka lumabas ng ospital, at ia-adjust namin ito kung kailangan mo pa ng higit pa. Hinahayaan naming nakalagay ang dressing sa loob ng humigit-kumulang 10 araw; pakiusap na huwag itong tatanggalin bago ang panahong iyon maliban kung sinabi namin sa iyo. Papalitan o tatanggalin namin ito kapag nakita ka namin. Pakiusap na magkaroon ng kasama sa loob ng unang 24 oras pagkauwi mo sa bahay.

Paggaling

Sa unang ilang araw, ang iyong hinlalaki at kamay ay magiging masakit at mamamaga. Unti-unti itong huhupa. Ang pagpapanatiling nakataas ng iyong kamay sa mga unan, kahit habang nagpapahinga o natutulog, ay nakatutulong upang mabawasan ang pamamaga at discomfort. Ang pain relief ay nakaplano bago ka lumabas ng ospital, kaya inumin ito ayon sa itinagubilin.

Ang iyong kamay ay magiging nasa isang splint na may mga dressing sa ibabaw ng sugat. Panatilihin ang dressing sa loob ng humigit-kumulang 10 araw, at papalitan o tatanggalin namin ito kapag nakita ka namin. Ang hand therapy pagkatapos ng operasyon ay kasama si Ruby Doolan sa Extend Rehabilitation. Si Ruby ay isang hand therapist: siya ang magdidirekta ng iyong mga ehersisyo at gagawa ng anumang splint na kailangan mo habang gumagaling ang iyong hinlalaki. Ang mga ehersisyo ay pinoprotektahan ang bagong joint sa simula, pagkatapos ay bubuo ng paggalaw at lakas habang ito ay humuhupa.

Hindi ka maaaring magmaneho habang nakasuot ang splint, dahil pinipigilan nito ang ligtas na paghawak mo sa manibela. Kapag natanggal na ang splint at binigyan ka na ng clearance ng iyong surgeon, maaari nang magmaneho muli. Tingnan ang aming pahina sa Driving after upper-limb surgery. Sa loob ng bahay, gamitin ang pagkakataon upang ipahinga ang iyong kamay at iwasan ang mabibigat na paghawak, pagbuhat, o mga gawaing may pagpikit hanggang sa sabihin ng iyong therapist na maaari na. Ang mga simpleng aktibidad tulad ng pagbibihis o paghahanda ng pagkain ay maaaring mas matagal sa simula, kaya dahan-dahan lamang at humingi ng tulong kapag kailangan mo ito.

Ang paggaling ay nag-iiba sa bawat indibidwal. Maaaring magkaiba ang iyong timeline, at gagabayan ka ng iyong surgeon at hand therapist sa bawat yugto.

Ano ang maaaring maging problema

Karamihan sa mga pasyente ay gumagaling nang maayos, ngunit paminsan-minsan ay maaaring magkaroon ng mga problema. Binabantayan kayo nang maigi ng inyong surgeon at ng team upang maagapan ang anumang isyu.

Maaaring lumuwag ang bagong joint sa paglipas ng panahon. Maaari ninyong maramdaman ang pagbabalik ng sakit sa base ng inyong thumb, o isang pakiramdam na tumutunog (clicking) o kumikiskis (grinding) kapag ginagalaw ito. Kung mangyari ito, banggitin ito sa inyong susunod na review.

Maaari ring ma-dislocate ang joint, ibig sabihin ay ang dalawang bahagi ng bagong joint ay nadulas palabas ng pwesto. Nagdudulot ito ng biglaang sakit at ang inyong thumb ay maaaring magmukhang wala sa hugis o pakiramdam ay unstable. Makipag-ugnayan agad sa clinic kung mapansin ito.

Maaaring mangyari ang patuloy na sakit na hindi nawawala. Kung ang mga simpleng painkiller ay hindi nakakapagpagaan nito, sabihin sa inyong surgeon sa oras ng review.

Ang maliit na buto ng wrist kung saan nakapatong ang thumb ay maaaring mag-crack habang isinasagawa ang operasyon. Karaniwan itong natutukoy habang nag-o-opera, ngunit kung mayroon kayong matalas na sakit na mas malala kaysa sa inaasahan pagkatapos nito, ipaalam sa clinic.

May ilang tao na nakakapansin ng pamamanhid o pangingilig sa likod ng thumb. Nangyayari ito kapag ang mga maliliit na nerve ng balat malapit sa sugat ay naiirita. Madalas itong nawawala sa paglipas ng panahon. Banggitin ito sa inyong review kung magpapatuloy ito.

Isang bihirang problema ay ang isang kondisyon ng sakit na nagdudulot ng paghapdi, pamamaga, at mga pagbabago sa balat sa kamay, na higit pa sa site ng operasyon. Kung ang inyong kamay ay maging masakit, namamaga, o sensitibo sa ganitong paraan, makipag-ugnayan agad sa clinic, dahil ang gamutan ay pinaka-epektibo kapag sinimulan nang maaga.

Ang tendon na nagtutuwid sa inyong thumb ay bihirang maputol (rupture) pagkatapos ng surgery. Maaari ninyong mapansin na hindi ninyo maituwid ang dulo ng inyong thumb. Makipag-ugnayan agad sa clinic kung mangyari ito.

Ang impeksyon ay hindi karaniwan ngunit seryoso. Bantayan ang malalim at tumitibok na sakit (throbbing pain) na hindi nawawala sa simpleng painkiller, pamumula na kumakalat mula sa sugat, lagnat, o likidong lumalabas mula sa hiwa. Kung makikita ang mga senyales na ito, makipag-ugnayan agad sa clinic, o pumunta sa emergency department pagkatapos ng oras ng opisina.

Kung ang joint replacement ay pumalya at nangangailangan ng isa pang operasyon, ang pagtanggal ng implant at pagsasagawa ng tendon-based procedure ay isang established na opsyon. Pag-uusapan namin ito nang detalyado sa inyo kung sakaling kailanganin ito.

Ang complications table sa pahinang ito ay naglilista ng mga tipikal na rate kung nais ninyo ang mga detalye.

Kailan dapat tumawag sa amin

Karamihan sa mga problema ay nawawala sa paglipas ng panahon, ngunit ang ilan ay nangangailangan ng mabilis na atensyon. Tumawag sa amin kung ikaw ay may lagnat, o kung ang sugat ay lalong namumula, namamaga, o nagsisimulang maglabas ng likido. Tumawag sa amin kung mayroon kang sakit na patuloy na lumalala sa kabila ng mga painkiller, o bagong pamamanhid sa iyong kamay o hinlalaki. Pumunta sa emergency kung mayroon kang biglaang matinding sakit, pamamaga sa iyong binti (calf), o kahirapan sa paghinga. Ang mga ito ay maaaring senyales ng blood clot. Pumunta sa emergency kung hindi mo na maigalaw ang iyong hinlalaki o kamay. Kung may nararamdamang mali at hindi ka sigurado, tumawag sa klinika. Mas gusto naming malaman ito nang maaga.

Saan maaaring magbasa nang higit pa tungkol sa kondisyon

Ang pahinang ito ay tungkol sa operasyon mismo. Ang kondisyong ginagamot nito, kabilang ang kung ano ang ipinapakita ng ebidensya tungkol sa kung kailan nakatutulong ang operasyon at kung kailan hindi, ay tinalakay nang mas detalyado sa pahinang Basal Thumb Arthritis.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

The Elektra prosthesis for trapeziometacarpal osteoarthritis demonstrated fast pain relief, maintenance of mobility, and a gradual increase in grip strength [1].
The Elektra prosthesis for trapeziometacarpal osteoarthritis had a revision rate of 44% after 72 months [1].
Trapeziometacarpal prosthesis enhances function, thumb length, and patient recovery in TMC arthrosis [2].
Limiting the magnitude of thumb loads after arthroplasty may contribute positively to the longevity of the procedure [3].
The Touch® trapeziometacarpal joint arthroplasty has a 96% implant survival rate at 2 years [4].
The Touch® trapeziometacarpal joint arthroplasty is recommended as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis [4].
The MOOVIS prosthesis is recommended for the treatment of advanced trapeziometacarpal osteoarthritis in people having an activity without too many manual constraints due to the absence of prosthesis instability [5].
The Elektra prosthesis for trapeziometacarpal osteoarthritis showed poor outcomes after 2 years, leading authors to not recommend this implant [6].
Total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility, clinical function, and high patient satisfaction [7].
The MAÏA trapeziometacarpal prosthesis represents a long-term solution for surgical treatment of thumb rhizarthrosis [8].
MAÏA TMC total joint arthroplasty provides very good results for pain relief, strength, mobility, and restoration of the thumb length [10].
MAÏA TMC total joint arthroplasty provides correction of most thumb z-deformities [10].

Anatomy & Pathophysiology

Bony Anatomy & Joint Mechanics

The thumb metacarpal is independent and articulates with the trapezium [26].
The thumb ray is the most divergent of the five rays of the hand [26].
The thumb has a more proximal and lateral position than the four fingers, allowing movement inward and outward from the palm [21].
The web space of the thumb is the largest and deepest of the hand [21].
The thumb is described as the master digit of the hand, representing the dominant element that gives value to all other digits [26].
The hand consists of 19 bones, 17 articulations, and 19 muscles situated entirely within the hand [21].

Prosthesis Design & Biomechanics

The Touch® prosthesis reproduces the concept of dual mobility consisting of a mobile prosthetic head in a polyethylene insert that is freely moveable within a metal cup [13].
The Touch® prosthesis comprises two concentric articulations: a smaller articulation between the head and polyethylene insert, and a larger articulation between the polyethylene insert and metal cup [13].
The Touch® prosthesis utilizes metal-on-polyethylene bearings [13].
The Touch® prosthesis is modular, composed of a titanium alloy stem (Ti–6Al–4 V), an M30 stainless steel intermediate implant, and an M30 stainless steel hemispheric cup [13].
The Touch® prosthesis head is covered by a pre-assembled high-density 7-mm diameter polyethylene insert [13].
Implant fixation for the Touch® prosthesis is achieved by a press-fit effect and a double-layer porous titanium and hydroxyapatite coating that promotes osteointegration [13].
The total in vitro range of motion of the Touch® prosthesis is 117 degrees [13].

Pathophysiology & Complications

Aseptic cup loosening is cited as the most common reason for implant failure in thumb carpometacarpal joint replacement, leading to revision rates of 42%–51% [15].
Proximal migration of the thumb is a major drawback of resection-suspension arthroplasty that can lead to compromised pinch strength and disability [15].
Polyethylene liner fracture in the Touch prosthesis can present as persistent clicking during thumb motion without antecedent trauma or pain [11].
Standard radiographs and CT scans may show a well-aligned implant without evidence of loosening in cases of polyethylene liner fracture [11].
Stress-view imaging (dynamic x-ray) using a fluoroscopic image intensifier can reveal instability of the carpometacarpal I joint and decentralization of the head compared with the cup in cases of polyethylene liner fracture [11].
Dynamic radiographic imaging with longitudinal traction is important for making a timely diagnosis of polyethylene liner fracture when standard radiographs are normal [14].
Revision surgery for polyethylene liner fracture involves exchanging only the liner, which restores stability [11].

Classification

The Touch® prosthesis reproduces the original concept of dual mobility as defined by Gilles Bousquet for a total hip prosthesis [13].
The Touch® prosthesis consists of a mobile prosthetic head in a polyethylene insert that is freely moveable within a metal cup [13].
The Touch® prosthesis was developed in 2013 based on the principle of a ball-and-socket joint with three degrees of freedom [13].
The Touch® prosthesis is modular and composed of a titanium alloy stem (Ti–6Al–4 V) available in five sizes [13].
The Touch® prosthesis includes an M30 stainless steel intermediate implant with a 4-mm diameter head covered by a pre-assembled high-density 7-mm diameter polyethylene insert [13].
The Touch® prosthesis polyethylene insert is available in three lengths and two angles [13].
The Touch® prosthesis includes an M30 stainless steel hemispheric cup available in two sizes (9 and 10 mm in diameter) [13].
Implant fixation for the Touch® prosthesis is primary by a press-fit effect and secondary by means of a double-layer porous titanium and hydroxyapatite coating [13].
The double-layer porous titanium and hydroxyapatite coating promotes and accelerates osteointegration [13].
The total in vitro range of motion of the Touch® prosthesis is 117° [13].

Clinical Presentation

Persistent clicking during thumb motion without antecedent trauma or pain can be a clinical sign of polyethylene liner fracture in a Touch prosthesis [11].
Grip and pinch strength may remain clinically unchanged compared with the contralateral side despite the presence of a fractured polyethylene liner [11].
Standard radiographs may appear normal in cases of polyethylene liner fracture, failing to reveal the diagnosis [14].
Computed tomography (CT) scans may demonstrate a well-aligned implant without evidence of loosening even when a polyethylene liner fracture is present [11].
Stress-view imaging using a fluoroscopic image intensifier can reveal instability of the carpometacarpal I joint during the application of translatory stress forces on the thumb [11].
Stress-view imaging may show a hint of possible decentralization of the prosthetic head compared with the cup in cases of polyethylene liner fracture [11].

Investigations

A careful physical examination is essential to direct care and future testing if indicated [17].

Treatment

Prosthetic Design and Mechanics

The Touch® prosthesis cup is available in two sizes: 9 and 10 mm in diameter [13].
Implant fixation for the Touch® prosthesis is primary by a press-fit effect and secondary by a double-layer porous titanium and hydroxyapatite coating [13].

Clinical Outcomes and Survival

Trapeziometacarpal prosthesis enhances function, thumb length, and patient recovery [2].
Total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function with high patient satisfaction [7].
The Elektra prosthesis for trapeziometacarpal osteoarthritis has a revision rate of 44% after 72 months [1].
The Elektra prosthesis for trapeziometacarpal osteoarthritis is not recommended due to poor outcomes after only 2 years [6].
MAÏA TMC joint prosthesis is a reliable long-term surgical procedure for TMC joint osteoarthritis, improving overall function beyond 10 years [19].
The Moovis prosthesis is recommended for the treatment of advanced trapeziometacarpal osteoarthritis for people having an activity without too many manual constraints [5].

Complications and Technical Considerations

A fracture of the polyethylene liner in a Touch trapeziometacarpal prosthesis can present as persistent clicking during thumb motion without antecedent trauma or pain [11].
Stress-view imaging using a fluoroscopic image intensifier can reveal instability of the carpometacarpal I joint and possible decentralization of the head compared with the cup in cases of suspected polyethylene liner fracture [11].
Exchanging only the polyethylene liner restores stability after a liner fracture in a Touch prosthesis [11].
Correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty with unconstrained cups [9].
Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure in Moovis arthroplasty [12].
Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis is not sufficiently reliable to be a routine solution for surgical revision of failed TMC arthroplasty or trapeziectomy [16].
Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis should be used with caution, primarily as a salvage solution if no safer alternative is available [16].
Aseptic cup loosening is the most common reason for implant failure in replacement arthroplasty, leading to revision rates of 42%–51% [15].

Complications

Polyethylene Liner Fracture

A 53-year-old male professional cook developed persistent clicking during thumb motion 12 months after Touch trapeziometacarpal arthroplasty for primary osteoarthritis [11].
Standard radiographs and CT scans in a patient with suspected polyethylene liner fracture may show a well-aligned implant without evidence of loosening [11].
Stress-view imaging using a fluoroscopic image intensifier can reveal instability of the carpometacarpal I joint and possible decentralization of the head compared with the cup when standard radiographs are normal [11].
Revision surgery for a suspected polyethylene liner fracture may confirm a fractured PE liner with an intact metallic head and stem [11].
Exchanging only the polyethylene liner can restore stability in cases of Touch prosthesis liner fracture [11].

Implant Survival and Revision

The Elektra prosthesis for trapeziometacarpal osteoarthritis had a revision rate of 44% after 72 months in a follow-up of 39 consecutive cases [1].
The Touch trapeziometacarpal joint arthroplasty reported a 96% implant survival rate at 2 years [4].
Aseptic cup loosening is cited as the most common reason for implant failure in thumb carpometacarpal replacement arthroplasty, leading to revision rates of 42%–51% [15].

Operative Complications and Technical Considerations

Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure in Moovis trapeziometacarpal joint arthroplasty [12].

Alternative Indications and Salvage

Recovery

Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure [12].
Correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty [9].
Exchanging only the liner restores stability following a polyethylene liner fracture in a Touch trapeziometacarpal prosthesis [11].

Key Evidence

[L4] Although the study observed fast pain relief, maintenance of mobility, and a gradual increase in grip strength, there was an increasing need for revision with a rate of 44% after 72 months. [1] (10.1177/1753193412443501)
[L3] Trapeziometacarpal prosthesis shows promise for TMC arthrosis, enhancing function, thumb length, and patient recovery, warranting further research and x-ray guidance. [2] (10.1016/j.jhsg.2024.03.004)
[L5] Limiting the magnitude of thumb loads after arthroplasty may contribute positively to the longevity of this procedure. [3] (10.1177/1753193416659230)
[L4] The study reports a 96% implant survival rate at 2 years with promising patient-reported and clinical outcomes, leading the authors to recommend surgery with the TouchRV prosthesis as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis. [4] (10.1177/17531934231179581)
[L4] The absence of prosthesis instability encourages us to recommend this technique for the treatment of advanced trapeziometacarpal osteoarthritis for people having an activity without too many manual constraints. [5] (10.1177/1558944718797341)
[L3] Because of these poor outcomes after only 2 years, the authors cannot recommend this implant. [6] (10.1177/1753193411414505)
[L3] Total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function with high patient satisfaction. [7] (10.1186/s12891-024-07439-5)
[L4] The MAÏA trapeziometacarpal prosthesis represents a long-term solution for surgical treatment of thumb rhizarthrosis. [8] (10.1177/17531934221136442)
[L4] This study shows that correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty. [9] (10.1177/1753193417741237)
[L4] 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. [10] (10.1016/j.jhsa.2017.06.008)
[L5] [11] (10.1016/j.jhsg.2026.101045)
[L2] Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure. [12] (10.1177/1753193420921307)
[L4] [13] (10.1177/17531934211024500)
[L4] This case highlights the importance of dynamic radiographic imaging with longitudinal traction to make a timely diagnosis of polyethylene liner fracture when standard radiographs are normal. [14] (10.1177/17531934241227918)
[L3] [15] (10.1177/1753193419873230)
[L5] Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis is not sufficiently reliable to be a routine solution for surgical revision of failed TMC arthroplasty or trapeziectomy; instead, it should be used with caution, primarily as a salvage solution if no safer alternative is available. [16] (10.1177/17531934231201914)
[L4] MAÏA TMC joint prosthesis is a reliable long-term surgical procedure for TMC joint osteoarthritis, improving overall function beyond 10 years. [19] (10.1016/j.jhsa.2024.03.019)

References

[1] Elektra prosthesis for trapeziometacarpal osteoarthritis: a follow-up of 39 consecutive cases. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412443501

[2] Comparative Analysis of Prosthetic (Touch) and Arthroplastic Surgeries for Trapeziometacarpal Arthrosis: Functional Outcomes and Patient Satisfaction With a 2-Year Follow-Up. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.03.004

[3] Total arthroplasty of basal thumb joint with Elektra prothesis: an in vitro analysis. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416659230

[4] Low complication rate and high implant survival at 2 years after Touch® trapeziometacarpal joint arthroplasty. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231179581

[5] Total Thumb Carpometacarpal Joint Arthroplasty: A Retrospective Functional Study of 28 MOOVIS Prostheses. HAND. 2018. DOI: 10.1177/1558944718797341

[6] Two-year outcomes of Elektra prosthesis for trapeziometacarpal osteoarthritis: a longitudinal cohort study. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193411414505

[7] Mid- and long-term clinical results of the Elektra and Moovis prosthesis for trapeziometacarpal joint replacement. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07439-5

[8] Long-term survival analysis of 191 MAÏA® prostheses for trapeziometacarpal arthritis. Journal of Hand Surgery (European Volume). 2022. DOI: 10.1177/17531934221136442

[9] Can surgical guidelines minimize complications after Maïa® trapeziometacarpal joint arthroplasty with unconstrained cups?. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417741237

[10] MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 80 Patients With More than 6 Years of Follow-Up. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.008

[11] Polyethylene Liner Fracture in Touch Trapeziometacarpal Prosthesis: A Case Report. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101045

[12] Two-year results of the Moovis trapeziometacarpal joint arthroplasty with focus on early complications. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420921307

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