Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up

Abstract

In this retrospective study, we report a series of 80 Arpe prostheses for trapeziometacarpal osteoarthritis in 63 patients. Twenty-seven prostheses (20 patients) were lost to follow-up. Twenty-one were revised, eight of them during the first year after operation. The calculated cumulated implant survival rate was 85% at 10 years but could be lower due to the lack of information on the patients lost to follow-up. The number of complications due to technical errors was high; but after we had done 30 cases, the number of early revisions decreased markedly. At follow-up, 23 of 32 thumbs were totally free of pain, and the patients were satisfied with 31 thumbs. We conclude that the implant survival declines progressively in the long run, with a survival rate of 80% after 15 years of follow-up and a further decline thereafter. We also found that this surgery was difficult to master. We advise selecting this implant for thumb trapeziometacarpal osteoarthritis with caution. Level of evidence: IV

A radiostereometric and clinical long-term follow-up study of the surface replacement trapeziometacarpal joint prosthesis

“…Especially key pinch grip was high in these patients and comparable with pinch grip in the normal population corrected for sex and age. These satisfying results are comparable with previously published long-term results [13][14][15][16][17][18].…”

“…After 10 years of follow-up, two out of ten prostheses were revised and two additional loose implants were found at the 10-year follow-up moment. Long-term survival is worse compared to recently published long-term results of the Roseland®, ARPE®, Ivory® and Rubis II prostheses, varying from 85 to 95% [13][14][15][16][17][18]. This is mainly explained by two early revisions.…”

Thumb CMCJ prosthetic total joint replacement: a systematic review

“…Quantifiable patient-reported outcome measures were reported in 34 studies. 5 – 38 Comparable pre and post-operative values were reported in 12 studies. 7 , 9 , 10 , 13 , 16 , 17 , 19 , 23 , 27 , 29 , 32 , 33 The most commonly used patient-reported outcome measures (PROMs) were the Disabilities of the Arm Shoulder and Hand measure (DASH) or quick DASH which are general upper extremity scoring systems.…”

“…Quantifiable range of motion measurements/scores were reported in 38 studies. 4 , 5 , 9 , 10 , 12 – 17 , 19 , 21 , 23 – 27 , 30 , 32 – 34 , 36 – 40 , 42 – 53 Comparable pre and post-operative values were reported in 13 studies. 10 , 13 , 19 , 23 , 24 , 27 , 33 , 34 , 36 , 39 , 48 , 50 , 53 Objective range of motion assessment included the Kapandji Opposition score, degrees of thumb abduction (either radial or palmar), and the Buck-Gramcko score, which is a measure of various movements.…”

Commentary on: Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up

“…Recently, several series of trapeziometacarpal implants have been published with a minimum of 10 years follow-up, with reported survival in the range of 85%–95% (Dumartinet-Gibaud et al., 2020; Martin-Ferrero et al., 2020; Tchurukdichian et al., 2020; Vissers et al., 2019). This could be compared with the UK benchmark for hip implants set by the National Institute of Health and Care Excellence in 2014, which stated that ‘individual hip replacement components are only recommended if 5% or fewer need revision at 10 years’ (www.nice.org.uk/guidance/ta304, accessed 22 February 2020).…”