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Meta-Analysis
. 2024 Nov;19(8):1242-1251.
doi: 10.1177/15589447231183172. Epub 2023 Jul 2.

Efficacy and Safety of Different Trapezium Implants for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review and Meta-Analysis

Ishith Seth  1 , Gabriella Bulloch  2 , Nimish Seth  3 , Quentin Fogg  2 , David J Hunter-Smith  1 , Warren M Rozen  1
Affiliations
Meta-Analysis

Efficacy and Safety of Different Trapezium Implants for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review and Meta-Analysis

Ishith Seth et al. Hand (N Y). 2024 Nov.

Abstract

Background: The trapeziometacarpal joint (TMCJ) is the most common hand joint affected by osteoarthritis (OA), and trapezium implant arthroplasty is a potential treatment for recalcitrant OA. This meta-analysis aimed to investigate the efficacy and safety of various trapezium implants as an interventional option for TMCJ OA. Methods: Web of Science, PubMed, Scopus, Google Scholar, and Cochrane library databases were searched for relevant studies up to May 28, 2022. Preferred Reported Items for Systematic Review and Meta-Analysis guidelines were adhered to, and the protocol was registered in PROSPERO. The methodological quality was assessed by National Heart, Lung, and Blood Institute tools for observational studies and the Cochrane risk of bias tool. Subgroup analyses were performed on different replacement implants; the analysis was done using Open Meta-Analyst software and P values <.05 were considered statistically significant. Results: A total of 123 studies comprising 5752 patients were included. Total joint replacement (TJR) implants demonstrate greater significant improvements in visual analogue scale pain scores postoperatively. Interposition with partial trapezial resection implants were associated with highest grip strength and highest reduction in the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Revision rates were highest in TJR (12.3%) and lowest in interposition with partial trapezial resection (6.2%). Conclusion: Total joint replacement and interposition with partial trapezial resection implants improve pain score, grip strength, and DASH scores more than other implant options. Future studies should focus on high-quality randomized clinical trials comparing different implants to accumulate higher quality evidence and more reliable conclusions.

Keywords: arthritis; arthroplasty; basal thumb arthritis; trapeziometacarpal; trapezium implants.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preferred Reported Items for Systematic Review and Meta-Analysis flow diagram of the included studies.
Figure 2.
Figure 2.
Change in pain score from baseline values (0-10), with the following subgroups: total joint replacement, interposition with partial trapezial resection, and interposition with total trapezial replacement. Note. CI = confidence interval.
Figure 3.
Figure 3.
Postoperative pain scores (0-10), with the following subgroups: total joint replacement, hemiarthroplasty, interposition with partial trapezial resection, and interposition with total trapezial replacement. Note. CI = confidence interval.
Figure 4.
Figure 4.
Postoperative patient satisfaction (1-10), with the following subgroups: total joint replacement, interposition with partial trapezial resection, and interposition with total trapezial replacement. Note. CI = confidence interval.
Figure 5.
Figure 5.
Change in grip strength from baseline values (kg), with the following subgroups: total joint replacement, hemiarthroplasty, interposition with partial trapezial resection, and interposition with total trapezial replacement. Note. CI = confidence interval.
Figure 6.
Figure 6.
Postoperative grip strength (kg), with the following subgroups: total joint replacement, hemiarthroplasty, interposition with partial trapezial resection, and interposition with total trapezial replacement. Note. CI = confidence interval.
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