A Cemented Surface Replacement Prosthesis in the Basal Thumb Joint

A Systematic Review of Postoperative Hand Therapy Management of Basal Joint Arthritis

“…A common theme in studies in which a Kirschner wire was used after the surgical procedure [3,6,14,15] was that patients were casted or splinted at least until the wire was removed, which occurred 4 to 5 weeks after surgery. For the studies in which some sort of joint prosthesis was implanted [1,9,18,20,21,24], postoperative immobilization time ranged from 2 to 6 weeks. The type of immobilization used for the studies was described in varying detail.…”

“…Some patients simply were shown exercises after the immobilization was discontinued [2,5,8,12,13,15,19]. Patients in other studies were referred to a therapist after the period of immobilization [1,3,4,7,9,24]. Finally, some patients were only referred to a therapist if it was felt they were not making satisfactory progress during followup visits [6,14,21,22].…”

“…Long thumb spica splint 6 weeks Heyworth et al [8] APB to FCR suspension 3 weeks in thumb spica splint Vadstrup et al [22] Trapeziectomy with APL interposition 3 weeks in thumb spica splint van Rijn and Gosens [24] Joint prosthesis (Avanta SR) (Small Bone Innovations) 2 weeks in thumb spica splint LRTI = ligament reconstruction and tendon interposition; FCR = flexor carpi radialis; APB = abductor pollicis brevis; APL = abductor pollicis longus; IP = interphalangeal.…”

Implant Arthroplasty of the Carpometacarpal Joint of the Thumb

“…These implants have been developed to limit the problem of loosening associated with total joint arthroplasty. 25 The Avanta SR TMC prosthesis (Fig. 3) is a cemented total surface replacement implant consisting of two saddle-shaped components to mimic the joint contour.…”

“…The trapezium is resurfaced with a chrome-cobalt alloy with a rounded peg for anchorage in the center of the carpal bone. 25 In a cadaveric study, Imaeda and colleagues 26 showed that resection arthroplasty and ball-andsocket joint replacements alter the normal kinematics of the thumb, thereby changing the musculotendinous moment arms and altering force transmission. Using a cadaveric model, Uchiyama and colleagues 10 showed the total joint surface replacement had similar kinematics and stability to the normal trapeziometacarpal joint, provided that a normal ligament tension was present.…”