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· DOS Abstracts
Trapezium resection vs. cemented cup revision in cup
failures of the trapeziometacarpal total joint prosthe-
ses of the thumb
Jens Knak, Torben Bæk Hansen
Department of Orthopaedics and The Orthopaedic Research Unit, Hospital
Unit West, Holstebro
Background:
Total joint prostheses may be used as treatment of trapeziometa-
carpal osteoarthritis of the thumb, but unfortunately a relatively high rate of
loosing of the trapezium component has been observed. Revision may be per-
formed as a cup revision or as a conversion into a trapeziectomy, but so far no
studies have been made to compare these two treatment options.
Purpose / Aim of Study:
The primary aim of this study was to compare the
outcome in patients with failure of the trapezium cup revised into a cemented
cup or into a trapeziectomy.
Materials and Methods:
We did a follow up-study in 44 patients (with 49
operations) revised in the period 2004 until 2014. 13 patients were excluded
because of a less than 12 months follow-up or declined to participate, and it left
us with 36 hands/operations in 31 patients, respectively 23 trapezium resec-
tions and 13 cup to cemented cup revisions. Clinical measures were VAS-score,
DASH, strength and movement of the thumb, and in all implants an AP and lat-
eral radiograph.
Findings / Results:
We did not find any difference regarding VAS-, DASH-
score, grip strength and movement of the thumb comparing. In the series of
cup revision we found a re-revision rate of 4 out of 18 operations (22%). These
4 patients were revised into trapeziectomy.
Conclusions:
Cup revision into trapeziectomy gives a good functional result,
and cup revision into a cemented new cup should be used in selected patients
only due to a high risk of re-revision.
31.
