High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis

Abstract

We retrospectively evaluated a consecutive series of 42 Motec thumb carpometacarpal total joint arthroplasties. The primary endpoint was revision with implant removal and trapeziectomy. At follow-up the disability of the arm shoulder and hand (DASH) score, pain on numerical rating scale at rest and with activity and serum chrome and cobalt concentrations were assessed for both unrevised and revised patients. At a mean followup of 26 months, 17 patients had been revised. The 2 year cumulative revision rate was 42% (95% CI, 28-60%). The DASH score and pain scores at rest and with activity were comparable between the patients whose thumbs remained unrevised and those revised. Patients with elevated serum chrome and cobalt levels had significantly higher DASH and pain scores, but elevated levels were not associated with revision. The revision rate in this study is unacceptably high. However, pain and DASH scores after revision are acceptable and comparable with patients with non-revised implants. Level of evidence: IV

Can surgical guidelines minimize complications after Maïa® trapeziometacarpal joint arthroplasty with unconstrained cups?

“…Loosening has been reported in up to 76% of the revised cases of certain prostheses (Thillemann et al., 2016). The cause of early loosening is a lack of primary press fit fixation and poor osteo-integration.…”

Surgical Treatment of Trapeziometacarpal Osteoarthritis (Review)

“…Данных о долгосрочных удовлетворительных результатах протезирования сустава не представлено. поэтому, несмотря на значительное количество исследований и многообразие конструкций, возможность протезирования до настоящего времени остается нерешенной проблемой в хирургии седловидного сустава [4,33,64]. Вне зависимости от выбранного способа операции на суставе, если хирургическое вмешательство выполняется на запущенных стадиях артроза, его неотъемлемой частью является коррекция деформации первого луча [33,65].…”

Current trends in the management of trapeziometacarpal arthritis

“…reported an unacceptably high 2-year revision rate of 42% for the metal-on-metal Motec™ prosthesis and advised careful monitoring with use of this implant. 38 …”