Failure Rates of Base of Thumb Arthritis Surgery

A Systematic Review

Aparna D. Ganhewa, Rui Wu, Michael P. Chae, Vicky Tobin, George S. Miller, Julian A. Smith, Warren M. Rozen, David J. Hunter-Smith

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Purpose: The purpose of the current review was to estimate failure rates of trapeziometacarpal (TMC) implants and compare against failure rates of nonimplant techniques for surgical treatment of TMC joint (basal thumb joint) arthritis. Methods: A systematic review was conducted to identify articles reporting on thumb implant arthroplasty and on nonimplant arthroplasty techniques for treatment of base of thumb arthritis in the English literature. The collected data were combined to calculate failure rates per 100 procedure-years. Failure was defined by the requirement for a secondary salvage procedure. The failure rates between different implant and nonimplant arthroplasty groups were compared directly and implants with higher than anticipated failure rates were identified. Results: One hundred twenty-five articles on implant arthroplasty and 33 articles on the outcome of nonimplant surgical arthroplasty of the TMC joint were included. The implant arthroplasty failure rates per 100 procedure-years were total joint replacement (2.4), hemiarthroplasty (2.5), interposition with partial trapezial resection (4.5), interposition with complete trapezial resection (1.7), and interposition with no trapezial resection (4.5). The nonimplant arthroplasty failure rates per 100 procedure-years were: trapeziectomy (0.49), joint fusion (0.52), and trapeziectomy with ligament reconstruction ± tendon interposition (0.23). Conclusions: Several implant designs (arthroplasties) had high rates of failure due to aseptic loosening, dislocation, and persisting pain. Furthermore, some implants had higher than anticipated failure rates than other implants within each class. Overall, the failure rates of nonimplant techniques were lower than those of implant arthroplasty. Type of study/level of evidence: Therapeutic IV.

Original languageEnglish
Pages (from-to)728-741.e10
Number of pages24
JournalJournal of Hand Surgery-American Volume
Volume44
Issue number9
DOIs
Publication statusPublished - Sep 2019

Keywords

  • Complications
  • failure
  • prosthesis
  • revision
  • thumb

Cite this

Ganhewa, Aparna D. ; Wu, Rui ; Chae, Michael P. ; Tobin, Vicky ; Miller, George S. ; Smith, Julian A. ; Rozen, Warren M. ; Hunter-Smith, David J. / Failure Rates of Base of Thumb Arthritis Surgery : A Systematic Review. In: Journal of Hand Surgery-American Volume. 2019 ; Vol. 44, No. 9. pp. 728-741.e10.
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abstract = "Purpose: The purpose of the current review was to estimate failure rates of trapeziometacarpal (TMC) implants and compare against failure rates of nonimplant techniques for surgical treatment of TMC joint (basal thumb joint) arthritis. Methods: A systematic review was conducted to identify articles reporting on thumb implant arthroplasty and on nonimplant arthroplasty techniques for treatment of base of thumb arthritis in the English literature. The collected data were combined to calculate failure rates per 100 procedure-years. Failure was defined by the requirement for a secondary salvage procedure. The failure rates between different implant and nonimplant arthroplasty groups were compared directly and implants with higher than anticipated failure rates were identified. Results: One hundred twenty-five articles on implant arthroplasty and 33 articles on the outcome of nonimplant surgical arthroplasty of the TMC joint were included. The implant arthroplasty failure rates per 100 procedure-years were total joint replacement (2.4), hemiarthroplasty (2.5), interposition with partial trapezial resection (4.5), interposition with complete trapezial resection (1.7), and interposition with no trapezial resection (4.5). The nonimplant arthroplasty failure rates per 100 procedure-years were: trapeziectomy (0.49), joint fusion (0.52), and trapeziectomy with ligament reconstruction ± tendon interposition (0.23). Conclusions: Several implant designs (arthroplasties) had high rates of failure due to aseptic loosening, dislocation, and persisting pain. Furthermore, some implants had higher than anticipated failure rates than other implants within each class. Overall, the failure rates of nonimplant techniques were lower than those of implant arthroplasty. Type of study/level of evidence: Therapeutic IV.",
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Failure Rates of Base of Thumb Arthritis Surgery : A Systematic Review. / Ganhewa, Aparna D.; Wu, Rui; Chae, Michael P.; Tobin, Vicky; Miller, George S.; Smith, Julian A.; Rozen, Warren M.; Hunter-Smith, David J.

In: Journal of Hand Surgery-American Volume, Vol. 44, No. 9, 09.2019, p. 728-741.e10.

Research output: Contribution to journalReview ArticleResearchpeer-review

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T2 - A Systematic Review

AU - Ganhewa, Aparna D.

AU - Wu, Rui

AU - Chae, Michael P.

AU - Tobin, Vicky

AU - Miller, George S.

AU - Smith, Julian A.

AU - Rozen, Warren M.

AU - Hunter-Smith, David J.

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N2 - Purpose: The purpose of the current review was to estimate failure rates of trapeziometacarpal (TMC) implants and compare against failure rates of nonimplant techniques for surgical treatment of TMC joint (basal thumb joint) arthritis. Methods: A systematic review was conducted to identify articles reporting on thumb implant arthroplasty and on nonimplant arthroplasty techniques for treatment of base of thumb arthritis in the English literature. The collected data were combined to calculate failure rates per 100 procedure-years. Failure was defined by the requirement for a secondary salvage procedure. The failure rates between different implant and nonimplant arthroplasty groups were compared directly and implants with higher than anticipated failure rates were identified. Results: One hundred twenty-five articles on implant arthroplasty and 33 articles on the outcome of nonimplant surgical arthroplasty of the TMC joint were included. The implant arthroplasty failure rates per 100 procedure-years were total joint replacement (2.4), hemiarthroplasty (2.5), interposition with partial trapezial resection (4.5), interposition with complete trapezial resection (1.7), and interposition with no trapezial resection (4.5). The nonimplant arthroplasty failure rates per 100 procedure-years were: trapeziectomy (0.49), joint fusion (0.52), and trapeziectomy with ligament reconstruction ± tendon interposition (0.23). Conclusions: Several implant designs (arthroplasties) had high rates of failure due to aseptic loosening, dislocation, and persisting pain. Furthermore, some implants had higher than anticipated failure rates than other implants within each class. Overall, the failure rates of nonimplant techniques were lower than those of implant arthroplasty. Type of study/level of evidence: Therapeutic IV.

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KW - failure

KW - prosthesis

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