Two-year results of the Moovis trapeziometacarpal joint arthroplasty with focus on early complications

Abstract

In this prospective study, we aimed to analyse the early results of 200 consecutive total trapeziometacarpal joint arthroplasties using the Moovis cup, a new generation, dual-mobility, uncemented conical cup, with special focus on early complications. At the 24-month follow-up, we found clinically relevant improvement of function and comfort. Among intraoperative complications were nine intraoperative trapezial fractures, which were treated by screw osteosynthesis; prolonged immobilization; and conversion to cemented cup fixation or primary or secondary trapeziectomy. One was left untreated as the loose cup did not cause notable symptoms. There were three implants with polyethylene wear and two with liner dislocation. We conclude that early outcomes of this new-generation implant are favourable, but its surgery is challenging and associated with important intraoperative and early postoperative complications related to the learning curve. Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure. Level of evidence: II

Low complication rate and high implant survival at 2 years after Touch® trapeziometacarpal joint arthroplasty

“…The 2-year survival rate of 96% is in line with data from other studies that have reported Touch V R prosthesis revision rates ranging from 0% (Falkner et al, 2023;Gonzalez-Espino et al, 2021) to 5% (Froschauer et al, 2021) in the first year and 4.6% up to 3 years after surgery (Lussiez et al, 2021). The reported survival rate is also similar to the 2-and 3-year survival rates of 97% for the Moovis V R implant (Dremstrup et al, 2021;Tchurukdichian et al, 2019). The Moovis V R prosthesis has a conical cup that differs from the spherical cup of the Touch V R implant.…”

“…Implantation of the metacarpal stem is a relatively easy procedure, but trapezial reaming, cup positioning and the choice of the correct neck size can be difficult. There is a considerable learning curve for the surgical technique and other authors have reported difficulties with their first implantations (Dremstrup et al., 2021; Froschauer et al., 2021). In addition, the selection criteria must be present: good trapezial bone stock without cysts, a trapezium height of at least 8 to 10 mm, no clinically relevant ST OA and no severe instability of the metacarpophalangeal joint.…”

“…Although older implant types are associated with a high risk of failure and subsequent revision rates of up to 25% (Holme et al., 2021; Kirkeby et al., 2021; Remy et al., 2020), the revision rates of dual-mobility implants, such as the Touch® (KeriMedical, Switzerland) or Moovis® (Stryker, USA) devices, have been reported to be below 5% in the first 3 years after arthroplasty (Dremstrup et al., 2021; Falkner et al., 2023; Froschauer et al., 2021; Gonzalez-Espino et al., 2021; Lussiez et al., 2021; Tchurukdichian et al., 2019). Further complications include de Quervain stenosing vaginosis and trigger thumb (Froschauer et al., 2021; Gonzalez-Espino et al., 2021; Lussiez et al., 2021), but an analysis of the adverse events related to these implant types and their treatment is currently lacking.…”

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

“…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). 23 These patients had a preoperative Quick-DASH of 49 points and a 2-year Quick-DASH of 16 points and an increase in grip strength from 21 kg before surgery to 29 kg after surgery. The same authors do highlight the difficulty of the procedure and advice on the learning curve of this implant.…”

“…[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). 23 These patients had a preoperative Quick-DASH of 49 points and a 2-year Quick-DASH of 16 points and an increase in grip strength from 21 kg before surgery to 29 kg after surgery.…”