The surgical gold standart treatment of the thumb osteoarthritis is the trapeziectomy with tendon interposition with ligament reconstruction. The trapeziometacarpal prosthesis is insufficiently assessed in literature.
Between 1994 and 2001, 43 trapeziometacarpal prosthesis Arpe were implanted by the same surgeon for isolated trapeziometacarpal degenerative osteoarthritis. The minimum follow-up is 5 years. 33 women and 2 men , average age 59,4-years, were operated after failure of conservative treatment. 7 patients were lost sight of (9 prosthesis) and 2 deaths (2 prosthesis). 26 other patients (32 prostheses) were examined by the author with an original revision questionnaire associated to the score of DASH.
7 revisions were necessary: 5 for loosening, 1 for premature dismemberment and 1 for recurrent partial dislocation. The survival of the prosthesis is 85% in 5 years. In the group of 25 prosthesis still implanted, there is no radiological sign of loosening, but in some cases a development of medial ossification. The average DASH score is 27,4/100. All the patients of this group are satisfied or very satisfied.
The prosthesis Arpe is an effective option in this series for the treatment of the degenerative trapeziometacarpal arthritis but its radioclinical control is necessary for the first year.