Revision of the Failed Thumb Carpometacarpal Arthroplasty

Papatheodorou, Loukia K.; Winston, Jonathan D.; Bielicka, Deidre L.; Rogozinski, Benjamin J.; Lourie, Gary M.; Sotereanos, Dean G.

doi:10.1016/j.jhsa.2017.07.015

Cited by 34 publications

(23 citation statements)

References 17 publications

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“…This is in concordance with two other papers, where the rate of reoperation has been stipulated to be 2-3 % (Cooney et al, 2006;Megerle et al, 2011), but the article does not discuss in detail the difficulties involved in addressing failed trapeziectomies surgically. This surgery is highly challenging and the results are unpredictable with success rates quoted from 20-84 % (Cooney et al, 2006;Megerle et al, 2011;Papatheodorou et al, 2017;Sadhu et al, 2016).…”

Section: Trapeziectomymentioning

confidence: 99%

Early Cup Loosening After Metal-on-Metal Total Joint Replacement of the Trapeziometacarpal Joint: A Retrieval Study

Thorkildsen

Johansson

Högmalm

et al. 2020

The Journal of Hand Surgery

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Section: Trapeziectomymentioning

confidence: 99%

Early Cup Loosening After Metal-on-Metal Total Joint Replacement of the Trapeziometacarpal Joint: A Retrieval Study

Thorkildsen

Johansson

Högmalm

et al. 2020

The Journal of Hand Surgery

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“…During the decision making for each revision procedure, other factors, such as the type of primary surgery, previous revisions, condition of the affected tissues and adjacent joints, play a role. Apart from our recommendations, other authors suggest different revision techniques, such as the use of the abductor pollicis longus tendon (Mattila and Waris, 2019; Megerle et al., 2011), distraction pinning with soft tissue interposition (Papatheodorou et al., 2017), implant arthroplasty (Ledoux, 2021; Umarji et al., 2012) or thumb MC to index MC arthrodesis (Ledoux, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Various techniques for revision surgery have been reported and include soft tissue interposition, implant arthroplasty or soft tissue interposition and distraction pinning (Cooney et al., 2006; Knak and Hansen, 2016; Munns et al., 2019; Papatheodorou et al., 2017). Only a few studies have investigated thumb CMC revision surgery and shown satisfactory outcomes; 50% to 75% of patients undergoing this procedure can expect good results (Cooney et al., 2006; Munns et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Outcomes and recommendations for revision of thumb carpometacarpal resection arthroplasty

Herren

Fuchs

Schindele

et al. 2021

J Hand Surg Eur Vol

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This study investigated revision surgery for the thumb after failed trapeziectomy with ligament reconstruction and tendon interposition and defined a revision concept. Twenty-four patients with 25 affected thumbs were examined at a mean of 5.5 years after their last revision operation. Pain during daily activities was 2.7 on a 0–10 numeric rating scale, pain at rest was 1.6 and the brief Michigan Hand Outcomes Questionnaire score was 63. Although 68% of patients indicated that their thumb was better than before primary surgery, the outcome after revision surgery was less favourable than that reported for primary trapeziectomy with ligament reconstruction and tendon interposition. We defined a revision algorithm to use as a guide for patients with residual symptoms after resection arthroplasty. The main reason for revision, symptomatic impingement of the thumb metacarpal, should be treated with resection of the metacarpal base and scaphotrapezoidal joint. An existing interposition should be revised, or a new interposition should be used, preferably with an autologous tendon or alternately with an allograft. Level of evidence: IV

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“…Thumb carpometacarpal (CMC) arthroplasty with resection of the trapezium and soft tissue interposition, with or without ligament reconstruction, has historically proven to be an efficacious treatment for thumb CMC arthritis 1–4. The incidence of failure following primary thumb CMC arthroplasty is low, with rates of revision surgery ranging from 2.5 to 2.9% at long-term follow-up 2,5.…”

mentioning

confidence: 99%

Arthrodesis of the First to Second Metacarpal for Definitive Management of Failed Thumb Carpometacarpal Arthroplasty: A Case Series

Taleghani

Moran

Ignozzi

et al. 2022

Techniques in Hand &Amp; Upper Extremity Surgery

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Thumb carpometacarpal (CMC) arthroplasty with resection of the trapezium and soft tissue interposition, with or without ligament reconstruction, has historically proven to be an efficacious treatment for thumb CMC arthritis. The incidence of failure following primary thumb CMC arthroplasty is low; however, the evaluation and management of a patient experiencing an unsatisfactory outcome following CMC arthroplasty is challenging. If symptoms are refractory to conservative measures, then revision surgical treatment may be indicated. Clinical decision making becomes even more complicated in cases of failure after an initial revision surgery has already been performed. In patients with a failed CMC arthroplasty revision in whom all soft tissue options have been exhausted, the senior author considers arthrodesis of the first metacarpal base to the second metacarpal base as a salvage procedure. The authors describe this surgical technique and present our experience with 4 cases in 3 patients who underwent this surgical intervention. Successful radiographic fusion was achieved in all 4 cases, with satisfactory clinical outcome in 3 out of 4 cases, supporting this surgical technique as a definitive option for patients who have failed multiple CMC arthroplasty revision surgeries.

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Revision of the Failed Thumb Carpometacarpal Arthroplasty

Cited by 34 publications

References 17 publications

Early Cup Loosening After Metal-on-Metal Total Joint Replacement of the Trapeziometacarpal Joint: A Retrieval Study

Early Cup Loosening After Metal-on-Metal Total Joint Replacement of the Trapeziometacarpal Joint: A Retrieval Study

Outcomes and recommendations for revision of thumb carpometacarpal resection arthroplasty

Arthrodesis of the First to Second Metacarpal for Definitive Management of Failed Thumb Carpometacarpal Arthroplasty: A Case Series

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