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. 2025 Jun 6;10(2):e25.00001.
doi: 10.2106/JBJS.OA.25.00001. eCollection 2025 Apr-Jun.

Early Clinical Failure of a Cementless Thumb Basal Joint Hemiarthroplasty for the Treatment of Trapeziometacarpal Osteoarthritis

Peter J Evans  1 , Patrick G Marinello  2 , Mark Shreve  3
Affiliations

Early Clinical Failure of a Cementless Thumb Basal Joint Hemiarthroplasty for the Treatment of Trapeziometacarpal Osteoarthritis

Peter J Evans et al. JB JS Open Access. .

Abstract

Background: The purpose of our study was to evaluate the clinical results and survivorship of a metal-stemmed implant for thumb basal joint hemiarthroplasty.

Methods: We performed 35 basal joint hemiarthroplasties in 32 patients. Of these, 26 thumbs (25 patients) had clinical follow-up of at least 12 months at our first review in 2014. The mean age of the patients was 54 years (range 43-68 years), and 88% were females. All patients had Eaton-Littler Stage II or III arthritis preoperatively. Average follow-up was 22.5 months (range 12-41 months) for the initial review and 144.4 months (range 126-160 months) for the last chart review and phone follow-up. The main outcomes were revision rate and time to revision. Preoperative and postoperative radiographs were examined to determine the amount of overall thumb ray lengthening and amount of subsidence of the implant between those revised and unrevised.

Results: At 12-month follow-up, 16 of 26 thumbs (61.5%) had been revised with implant removal, resection of the remaining trapezium, and ligament reconstruction with tendon interposition. Another 3 thumbs were symptomatic and planning on future revision. Continued pain, stem loosening, and implant subsidence into the trapezium were the clinical reasons for revision. The mean time to revision was 18.1 months (range 8-41 months).

Conclusions: We found poor implant survivorship and an unacceptably high rate of reoperation with the stemmed thumb basal joint hemiarthroplasty device in our patient cohort.

Level of evidence: Therapeutic Study-Level IV Case Series. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A834).

Figures

Fig. 1
Fig. 1
Preoperative radiograph showing typical arthrosis of the THUMB CMC joint in 2 patients (Fig. 1-A) and (Fig. 1-B).
Fig. 1
Fig. 1
Preoperative radiograph showing typical arthrosis of the THUMB CMC joint in 2 patients (Fig. 1-A) and (Fig. 1-B).
Fig. 2
Fig. 2
Immediate postoperative (Fig. 2-A) and revision at 8 months (Fig. 2-B) demonstrating catastrophic implant failure due to stem loosening necessitating revision to LRTI. LRTI = ligament reconstruction with tendon interposition arthroplasty.
Fig. 2
Fig. 2
Immediate postoperative (Fig. 2-A) and revision at 8 months (Fig. 2-B) demonstrating catastrophic implant failure due to stem loosening necessitating revision to LRTI. LRTI = ligament reconstruction with tendon interposition arthroplasty.
Fig. 3
Fig. 3
Immediate postopeartive (Fig. 3-A), at 3 months postopeartive without subsidence (Fig. 3-B), at 1 year with substantial subsidence (Fig. 3-C), and at 3 years demonstrating significant complete trapezial subsidence necessitating revision to LRTI (Fig. 3-D). LRTI = ligament reconstruction with tendon interposition arthroplasty.
Fig. 3
Fig. 3
Immediate postopeartive (Fig. 3-A), at 3 months postopeartive without subsidence (Fig. 3-B), at 1 year with substantial subsidence (Fig. 3-C), and at 3 years demonstrating significant complete trapezial subsidence necessitating revision to LRTI (Fig. 3-D). LRTI = ligament reconstruction with tendon interposition arthroplasty.
Fig. 3
Fig. 3
Immediate postopeartive (Fig. 3-A), at 3 months postopeartive without subsidence (Fig. 3-B), at 1 year with substantial subsidence (Fig. 3-C), and at 3 years demonstrating significant complete trapezial subsidence necessitating revision to LRTI (Fig. 3-D). LRTI = ligament reconstruction with tendon interposition arthroplasty.
Fig. 3
Fig. 3
Immediate postopeartive (Fig. 3-A), at 3 months postopeartive without subsidence (Fig. 3-B), at 1 year with substantial subsidence (Fig. 3-C), and at 3 years demonstrating significant complete trapezial subsidence necessitating revision to LRTI (Fig. 3-D). LRTI = ligament reconstruction with tendon interposition arthroplasty.
Fig. 4
Fig. 4
Intraoperative photograph of exposure for removal of BioPro Hemiarthroplasty.
See this image and copyright information in PMC

References

    1. Patel TJ, Beredjiklian PK, Matzon JL. Trapeziometacarpal joint arthritis. Curr Rev Musculoskelet Med. 2012;6(1):1-8. - PMC - PubMed
    1. Spaans AJ, van Laarhoven CMCM, Schuurman AH, van Minnen LP. Interobserver agreement of the eaton-littler classification system and treatment strategy of thumb carpometacarpal joint osteoarthritis. J Hand Surg Am. 2011;36(9):1467-70. - PubMed
    1. Dela Rosa TL, Vance M, Stern P. Radiographic optimization of the Eaton classification. J Hand Surg Br. 2004;29(2):173-7. - PubMed
    1. Ulrich-Vinther M, Puggaard H, Lange B. Prospective 1-year follow-up study comparing joint prosthesis with tendon interposition arthroplasty in treatment of trapeziometacarpal osteoarthritis. J Hand Surg Am. 2008;33(8):1369-77. - PubMed
    1. Igoe D, Middleton C, Hammert W. Evolution of basal joint arthroplasty and technology in hand surgery. J Hand Ther. 2014;27(2):115-21. - PubMed

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