ABSTRACT
We performed 88 primary ball-and-socket arthroplasties of the trapeziometacarpal joint in 84 patients (69 women and 15 men) with a mean age of 61 years (37 to 81). Cemented de la Caffinière prostheses were implanted in 43 joints from 1988 to 1991 and 45 cementless Ledoux implants were used between 1992 and 1994. Of the 61 surviving prostheses still in situ, 51 were reviewed clinically and radiologically with a mean follow-up of 25 months for the Ledoux and 63 months for the de la Caffinière implant. The survival rate for the Ledoux prosthesis was 58.9% at 16 months and for the de la Caffinière implant 66.4% at 68 months. Loosening occurred in 15% of the Ledoux stems, in 46% of the Ledoux cups, in 24% of the de la Caffinière stems and in 28% of the de la Caffinière cups. Both prostheses behaved similarly, and it is clear that a constrained ball-and-socket prosthesis is not suitable for the trapeziometacarpal joint.
Subject(s)
Arthroplasty, Replacement , Finger Joint/surgery , Joint Prosthesis , Osteoarthritis/surgery , Adult , Aged , Aged, 80 and over , Arthritis, Rheumatoid/surgery , Cementation , Female , Finger Joint/physiopathology , Humans , Male , Middle Aged , Osteoarthritis/physiopathology , Prosthesis Design , Range of Motion, ArticularABSTRACT
Between 1988 and 1994, eighty-eight trapeziometacarpal arthroplasties were performed on eighty-four patients (69 females and 15 males), with a mean age of 61 years (37 to 81). Forty-five Ledoux and forty-three De la Caffinière prosthesis were implanted. Of the 61 non-reoperated prosthesis, 51 were reviewed with a mean follow-up of 25 months for the Ledoux prosthesis and 63 months for the De la Caffinière prosthesis. Survival rate was 58.8% at 16 months for the Ledoux prosthesis and 66.4% at 68 months for the De la Caffinière prosthesis, with a statistically significant difference (p < 0.001). In the Ledoux group, 15% of the shafts and 46% of the cups were loose. In the De la Caffinière group 24% of the shafts and 28% of the cups were loose. The final outcome of both prosthesis was similar, and we therefore concluded that spherical prostheses fixed in the trapezium are inadequate for the trapeziometacarpal joint.
