DOS Kongressen 2014 ·
79
High early revision rate in a new cemented
polyethylene cup in trapeziometacarpal total joint
arthroplasty
Jens Knak, Torben Bæk Hansen
Department of Orthopaedics and The Orthopaedic Research Unit, Hospital
Unit West, Holstebro
Background:
Trapeziometacarpal total joint arthroplasty may be used in treat-
ment of trapeziometacarpal osteoarthritis preserving the length of the thumb
and providing rapid rehabilitation and good grip strength. Unfortunately high
revision rates have been reported, and new implant designs strive to reduce the
revision rates.
Purpose / Aim of Study:
To evaluate the mid term results using a new ce-
mented cup design with the Motec polyethylene trapezium cup in ball and sock-
et trapeziometacarpal total joint arthroplasty.
Materials and Methods:
We did a prospective study in 58 patients, 11 males
and 39 females, mean age 61 years (range 41-77) operated with a Motec poly-
ethylene trapezium cup in the period december 2010 to November 2012. All
patients were followed with DASH score, VAS and measurement of grip strength
as well as radiological follow- up at 3, 12 and 24 months.
Findings / Results:
After a mean follow-up of 33 months (range 19-43) 8 pa-
tients had been revised due to early aseptic loosening or osteonecrosis, (14%),
2 patients due to recidivant luxation, 1 patient due to traumatic cup loosening
and 1 patient due to deep infection. 5 of the 8 patients with aseptic loosening/
osteonecrosis were revised during the first 12 months. The clinical results in the
remaining 47 patients were equivalent to other published series.
Conclusions:
The early revision rate due to aseptic loosening or osteonecrosis
has been surprisingly high indicating a technical failure during cementing. We
suspect heat induced bone necrosis to be a possible cause, and further studies
are needed looking at the cementation technique in trapeziometacarpal total
joint arthroplasty.
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