Total arthroplasty with Ivory® prosthesis versus resection–suspension arthroplasty: a retrospective cohort study on 82 carpometacarpal-I osteoarthritis patients over 4 years

Abstract

Background: To elucidate the performance of carpometacarpal-I joint prostheses in comparison with the current gold standard treatment, resection-suspension arthroplasty (RA), we conducted a study comparing outcomes of the Ivory prosthesis to those of a cohort of patients receiving RA.Methods: Initially, we had enrolled 34 prosthesis patients and 48 RA patients, of which 5 and 11 were lost to followup. We defined Eaton/Littler stage 3 osteoarthritis, no previous surgery, no concomitant arthrosis, no rheumatic arthritis, no history of trauma and a minimum follow-up period of 2 years as inclusion criteria. We assessed patient demographics, disability of the arm, shoulder, and hand score, pain via visual analogue scale, subjective strength of the thumb, range of motion (radial and palmar abduction and opposition), and patient satisfaction. All occurring complications were recorded.Results: Follow-up included a mean period of 4.5 years (2-7.4) in the prosthesis cohort and 4.1 years (2-6.8) in the RA group. Disability of the arm, shoulder, and hand scores, pain scores, palmar abduction and opposition, and subjective satisfaction showed no significant differences between the two cohorts. Postoperative loss of strength was significantly less in the prosthesis group (p = 0.01). Moreover, we were able to demonstrate better range of motion in terms of radial abduction in the prosthesis group (p = 0.001). The overall complication rate was significantly higher in the prosthesis cohort (41.4% vs. 10.8%) (p = 0.008). Nevertheless, the Ivory prosthesis group showed a survival rate of 93.1%. Conclusion:As the high complication rate is compensated by a better functional outcome (enhanced range of motion and strength), we believe that prosthesis implantation can be a reasonable treatment option for carpometacarpal-I osteoarthritis in a particular patient group. Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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

“…Several studies have been published comparing total joint arthroplasty with trapeziectomy, but only reporting short-term results [1][2][3][4][5]. Jager et al described higher satisfaction, mobility, strength, pain reduction and functional scores in favor of the MAIA® total joint prosthesis [1].…”

“…The two most widely used surgical procedures for the treatment of osteoarthritis (OA) of the trapeziometacarpal (TMC) joint are the trapeziectomy and TMC joint arthroplasty. In recently published research it is hypothesized that TMC joint arthroplasty is superior compared to trapeziectomy in terms of pain, strength, range of motion (ROM), satisfaction and recovery [1][2][3][4][5]. However, most studies present short-term follow-up and thus long-term data are of interest.…”

Trapeziectomy versus joint replacement for first carpometacarpal (CMC 1) joint osteoarthritis: a systematic review and meta-analysis

“…After removal of duplicates and abstract screening, 27 articles were assessed for eligibility by the inclusion criteria. From these 27 studies, 13 were excluded, resulting in 14 eligible studies [20][21][22][23][24][25][26][27][28][29][30][31][32][33]. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a flow diagram for the results of the study selection procedure is shown in Fig.…”

“…All five studies [21][22][23][24][25] that compared JR with LRTI alone used the Burton-Pellegrini technique. Four studies adopted RA techniques, of which three [20,26,28] used RSA and one [27] used Lundsborg's RA. The studies utilising TI adopted flexor carpi radialis (FCR) TI [29] and abductor pollicis longus (APL) TI [30].…”

Trapeziometacarpal osteoarthritis – a stepwise therapeutic approach

“…Non-cemented prostheses provide better results in mid-term follow-up [66,67], high rates of patient satisfaction and 71-92% survival rates in a 10-year follow-up [68,69]. There is a lack of prospective studies directly comparing trapeziectomy with the different prostheses [59], but at present overall prosthetic implants seem to have a higher complication rate and inferior long-term outcomes compared with resection arthroplasty [69,70].…”