Complications Related to Metal-on-Metal Articulation in Trapeziometacarpal Joint Total Joint Arthroplasty

Abstract

Adverse reactions to metal-on-metal (MoM) prostheses are well known from total hip joint resurfacing arthroplasty with elevated serum chrome or cobalt, pain and pseudo tumor formation. It may, however, also be seen after total joint replacement of the trapeziometacarpal joint using MoM articulation, and we present two cases of failure of MoM prostheses due to elevated metal-serum levels in one case and pseudo tumor formation in another case. Furthermore, we suggest a diagnostic algorithm for joint pain after MoM trapeziometacarpal joint replacement based on published experiences from MoM hip prostheses and adverse reactions to metal.

Combined replacements of the wrist, ulnar head, and thumb carpometacarpal joint. Case report, technical note and recent evidence to the Arpe™ prosthesis

“…At two midand one long-term follow-up's a survival rate for in-vivo functional Arpe TM prostheses was found in 85-97% of cases [34,37,38]. Currently, none of all other types for total TCMJ replacements (ceramics or metal-on-metal articulation types) or TCMJ pyrocarbon interposition implants (Pi2) revealed a survival rate of 93.9% at a 10-year followup, and the results with the Arpe TM prosthesis are comparable with those of the standard reference of 93,1% in hip arthroplasty [38][39][40][41][42].…”

Pyrocardan Implant Arthroplasty for Carpometacarpal Osteoarthritis of the Thumb: A Comparative Study with a Historical Control Group

“…Earlier designs of a total joint replacement have been discouraging with metal-on-metal pseudotumor formation, metal and polyethylene wear, and dislocation of the prosthesis. [17][18][19][20] Nevertheless, the new dual-mobility designs seem promising with good function and low long-term revision rates. 21 In 2020, very promising short-term results were published with the Moovis prosthesis in 200 cases with acceptable revision rates (Dremstrup et al, 2021).…”

Chrome nitride coating reduces wear of small, spherical CrCoMo metal-on-metal articulations in a joint simulator

“…One patient had pseudotumour formation and the second had elevated serum Chromium and cobalt levels with local skin irritation. At surgery there was slight discoloration of the periprosthetic tissue and signs of asymmetric component wear (Frolich and Hansen, 2015). In light of this and previous experience with MoM arthroplasty from other joints, our findings of wear reduction are of interest.…”