Abstract
Objective When revising a failed patella-type trapeziometacarpal (TMC) prosthesis, in some cases it may be necessary to remove the metacarpal stem. The purpose of this work is to present a new surgical technique to remove the metacarpal stem and present the results of secondary trapeziectomy after a failed TMC patella-type prosthesis.
Methods A retrospective review was conducted on a case series of 12 patients who underwent revision surgery for a failed TMC prosthesis between 2007 and 2019. Epidemiological and clinical data were recorded, including visual analog scale (VAS) and Quick DASH, and were statistically analyzed using SPSS® statistical software.
Results In all cases the stem could be removed without complications. The average prosthesis survival time was 32.3 months (range 11.5-53.2) and the average follow-up time after revision surgery was 34.9 months (range 14.4-55.4). The VAS mean was 4.0 (95% CI: 2.4-5.6) with a range of 0 to 8. The quick DASH mean was 52.1 (95% CI: 37.0-67.3).
Conclusion The presented surgical technique provides a useful resource to remove the stem if necessary. The results of secondary trapeziectomy may not be as good as expected.
Keywords trapeziometacarpal prosthesis - ligamentoplasty - joint replacement - teview - failure
