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Herren DB, Beaulieu JY, Calcagni M, Erling C, Jung M, Kaulich A, Mühldorfer-Fodor M, Papaloïzos M, Rosenkranz A, Vögelin E, Marks M. [Current Trends in the Implantation of the Touch Prosthesis at the Thumb Carpometacarpal Joint: Results of the 1st German-Speaking User Meeting]. HANDCHIR MIKROCHIR P 2024; 56:201-211. [PMID: 38861975 PMCID: PMC11166473 DOI: 10.1055/a-2321-9426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/09/2024] [Indexed: 06/13/2024] Open
Abstract
The introduction of the new generation of thumb carpometacarpal (CMC I) joint implants for the treatment of CMC I osteoarthritis has significantly broadened the scope of hand surgery in recent years. However, the technical demands of the procedure and the many details that need to be considered require appropriate training and a learning curve. To share experiences with the Touch CMC I prosthesis, we held the first German-speaking CMC I joint prosthetics user meeting in Zurich. After some basic introductory lectures on biomechanics and the principles of prosthetic fitting of the CMC I joint, the various challenges associated with CMC I joint prosthetics were discussed in interactive expert panels. Subsequently, cases were discussed in small groups under expert guidance and the respective conclusions were discussed in plenary. The main results of this symposium are summarised in this manuscript.
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Affiliation(s)
| | - Jean-Yves Beaulieu
- Unité Chirurgie de la main, Hôpitaux universitaires de Genève, Genf,
Switzerland
| | - Maurizio Calcagni
- Klinik für Plastische Chirurgie und Handchirurgie, Universitätsspital
Zürich, Zürich, Switzerland
| | | | - Martin Jung
- Handchirurgie, OCM Orthopädische Chirurgie München, München,
Germany
| | - Axel Kaulich
- Handchirurgie, Hanusch Krankenhaus, Orthopädie und Traumatologie, Wien,
Austria
| | | | | | - Anton Rosenkranz
- Abteilung Orthopädie und Traumatologie, Krankenhaus St. Josef Braunau,
Braunau am Inn, Austria
| | - Esther Vögelin
- Universitätsklinik für Plastische- und Handchirurgie, Inselspital,
Bern, Switzerland
| | - Miriam Marks
- Lehre, Forschung und Entwicklung, Schulthess Klinik, Zürich,
Switzerland
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Sánchez-Crespo MR, Couceiro-Otero J, Del Canto-Alvarez FJ, Ayala-Gutiérrez H, Holgado-Fernández M. [Translated article] Experience in major complications with total trapezometacarpal prostheses. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T181-T189. [PMID: 38232935 DOI: 10.1016/j.recot.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/10/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION The treatment of rhizarthrosis using trapeziometacarpal prostheses (TMP) is increasing. Complications may lead to loss of the implant and result in salvage surgery. Our aim was to assess major complications with the use of some TMP models and their rescue. MATERIAL AND METHOD Retrospective study on TMP implanted between 2006 and 2021. Models studied: Arpe®, Elektra®, Ivory®, Maïa®, Isis® and Touch®. Demographic data were assessed, implant placement by radiographic study, technical data, complications, salvage surgeries and final survival. RESULTS Review of 224 TMP, 45 Arpe® (95.5% survival, rate follow-up [R] 6-16 years), 5 Elektra® (80% survival, R 13-14), 14 Ivory® (92.8% survival, R 9-11), 7 Maïa® (100% survival, R 8-9), 115 Isis® (99.1% survival, R 1-8), 38 Touch® (100% survival, R 1-4). The medial angle of the dome with the proximal articular surface of the trapezium in the lateral plane, was: Arpe®: 8.85°, Elektra®: not assessable, Ivory®: 6.6°, Maïa®: 14.4°, Isis®: 3.8°, and Touch®: 5.95°. The Isis® was placed 100% with scopic guidance presenting a significantly lower angle respect to the medial angle of the dome with the proximal articular surface of the trapezium. As main complications, we observed 3.5% of dislocations and 4% of mobilisations, with the Elektra® being responsible for 47% of these. Nineteen salvage surgeries were performed, with 3% of the implants being lost. CONCLUSIONS Dislocation and mobilisation are the most observed complications, the Elektra® responsible for almost half of them. Correct placement and implant design appear to be crucial to avoid them in the short and long term.
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Affiliation(s)
- M R Sánchez-Crespo
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Departamento de Medicina y Cirugía, Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, Spain.
| | - J Couceiro-Otero
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Escuela de Fisioterapia Gimbernat Cantabria, Torrelavega, Cantabria, Spain
| | - F J Del Canto-Alvarez
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain; Departamento de Medicina y Cirugía, Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, Spain
| | - H Ayala-Gutiérrez
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - M Holgado-Fernández
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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Sánchez-Crespo MR, Couceiro-Otero J, Del Canto-Alvarez FJ, Ayala-Gutiérrez H, Holgado-Fernández M. Experience in major complications with total trapezometacarpal prostheses. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:181-189. [PMID: 37918688 DOI: 10.1016/j.recot.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/02/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The treatment of rhizarthrosis using trapeziometacarpal prostheses (TMP) is increasing. Complications may lead to loss of the implant and result in salvage surgery. Our aim was to assess major complications with the use of some TMP models and their rescue. MATERIAL AND METHOD Retrospective study on TMP implanted between 2006 and 2021. Models studied: Arpe®, Elektra®, Ivory®, Maïa®, Isis® and Touch®. Demographic data were assessed, implant placement by radiographic study, technical data, complications, salvage surgeries and final survival. RESULTS Review of 224 TMP, 45 Arpe® (95.5% survival, rate follow-up [R] 6-16 years), 5 Elektra® (80% survival, R 13-14), 14 Ivory® (92.8% survival, R 9-11), 7 Maïa® (100% survival, R 8-9), 115 Isis® (99.1% survival, R 1-8), 38 Touch® (100% survival, R 1-4). The medial angle of the dome with the proximal articular surface of the trapezium in the lateral plane, was: Arpe®: 8.85°, Elektra®: not assessable, Ivory®: 6.6°, Maïa®: 14.4°, Isis®: 3.8°, and Touch®: 5.95°. The Isis® was placed 100% with scopic guidance presenting a significantly lower angle respect to the medial angle of the dome with the proximal articular surface of the trapezium. As main complications, we observed 3.5% of dislocations and 4% of mobilisations, with the Elektra® being responsible for 47% of these. Nineteen salvage surgeries were performed, with 3% of the implants being lost. CONCLUSIONS Dislocation and mobilisation are the most observed complications, the Elektra® responsible for almost half of them. Correct placement and implant design appear to be crucial to avoid them in the short and long term.
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Affiliation(s)
- M R Sánchez-Crespo
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Departamento de Medicina y Cirugía, Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, España.
| | - J Couceiro-Otero
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Escuela de Fisioterapia Gimbernat Cantabria, Torrelavega, Cantabria, España
| | - F J Del Canto-Alvarez
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Departamento de Medicina y Cirugía, Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, España
| | - H Ayala-Gutiérrez
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - M Holgado-Fernández
- Unidad de Mano y Muñeca, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
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De Vitis R, Taccardo G, Passiatore M. Re: Herren DB, Marks M, Neumeister S, Schindele S. Short-term recovery after implant versus resection arthroplasty in trapeziometacarpal joint osteoarthritis. J Hand Surg Eur. 2023. J Hand Surg Eur Vol 2024; 49:384-385. [PMID: 37882701 DOI: 10.1177/17531934231206267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Affiliation(s)
- Rocco De Vitis
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS - Roma - UOC di Ortopedia e Chirurgia della Mano, Rome, Italy
| | - Giuseppe Taccardo
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS - Roma - UOC di Ortopedia e Chirurgia della Mano, Rome, Italy
| | - Marco Passiatore
- ASST Spedali Civili di Brescia. S.C. Ortopedia e Traumatologia - Clinica Ortopedica, Brescia, Italy
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Van Geel P, Decramer A, Top A, Muermans S, Ryckaert T, Vanmierlo B. Thumb Arthroplasty as Reliable Long-term Solution for Trapeziometacarpal Osteoarthritis: A Minimum of 15 Years of Follow-up. Hand (N Y) 2024:15589447241233367. [PMID: 38389259 DOI: 10.1177/15589447241233367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND In patients with symptomatic trapeziometacarpal (TMC) joint arthritis resistant to conservative treatment, surgical treatment can be advised. One of the many surgical treatment options is TMC arthroplasty. The Arpe prosthesis is one example of these TMC arthroplasties. METHODS This retrospective study evaluated patients who underwent TMC arthroplasty with the Arpe prosthesis after a minimum of 15 years of follow-up. Clinical, radiologic, and qualitative outcomes were assessed for 43 Arpe arthroplasties in 41 patients, of whom 2 had bilateral arthroplasties. The female to male ratio was 39:4. The mean follow-up time was 197 months (range = 180-225). RESULTS The cumulative survival rate after a mean of 16.5 years was 84%. Seven failures (16%) were registered, of which 5 during the first 3 years after primary surgery. All patients were successfully converted to a trapeziectomy. Quick Disabilities of the Arm, Shoulder and Hand score improved with 44.9 points and visual analogue pain score with 97% and 91% at rest and during exercise, respectively. CONCLUSIONS This series demonstrates that thumb arthroplasty is a reliable long-term solution for thumb base arthritis, with significant pain reduction and functional improvement, even after 15 years of follow-up.
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Affiliation(s)
- Pieter Van Geel
- Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium
| | - Arne Decramer
- Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium
| | - Alexander Top
- Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium
| | - Stijn Muermans
- Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium
| | | | - Bert Vanmierlo
- Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium
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Ledoux P. Contribution to the study of stresses in the thumb column during key pinch grip. HAND SURGERY & REHABILITATION 2024; 43:101603. [PMID: 37806637 DOI: 10.1016/j.hansur.2023.09.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES The aim of this study was to calculate the stress acting on the trapeziometacarpal joint during an key pinch grip. METHOD We used profile X-rays of the thumb to measure the various bony and muscle lever arms. We assessed the angles of action of the muscular elements involved in the thumb column. Based on this data, we established a two-dimensional geometric model that enabled us to determine the forces at each joint level, as a function of stresses and muscular contributions. We were also able to calculate the participation of the different muscle groups in obtaining a balanced situation. RESULTS Our results, as a function of the degree of flexion of the interphalangeal and metacarpophalangeal joints, show a multiplying factor of 2.9-3.19 in relation to the key pinch grip force. DISCUSSION Previous studies modelling a key pinch grip are showed multiplying factors from 6 to 13 in relation to the key pinch grip force. They are not compatible with the characteristics of the polyethylene used for trapeziometacarpal prostheses, whereas numerous articles in the literature show survival rates that are more or less comparable to those of total hip prostheses. These studies required an excessive number of assumptions, which could lead to error. Our results are compatible with the results of trapeziometacarpal prosthesis and with those of a recent study measuring intra-articular trapeziometacarpal pressure in a cadaveric model. Our model allows us to test different configurations of the thumb spine depending on the degree of flexion of the interphalangeal and metacarpophalangeal joints.
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Affiliation(s)
- Pascal Ledoux
- Polyclinique des 3 Vallées, 4 Route de Saint Pons, 34600 Bédarieux, France.
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Muir L. Trapeziometacarpal joint arthritis - imaging and implants: commentary and personal opinions. J Hand Surg Eur Vol 2023; 48:159-161. [PMID: 36524279 DOI: 10.1177/17531934221143439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Lindsay Muir
- Salford Royal NHS Foundation Trust, Salford, UK.,
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