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J Wrist Surg 2024; 13(02): 142-150
DOI: 10.1055/s-0043-1770793
Scientific Article

Trapeziectomy versus Maïa Prosthesis in Trapeziometacarpal Osteoarthritis

Christian M. Windhofer 
1   Department Traumatology, AUVA Trauma Center Salzburg, Salzburg, Austria
2   Ludwig-Boltzmann-Institute for Experimental and Clinical Traumatology in AUVA Trauma Research Center, Wien, Austria
,
Johann Neureiter
1   Department Traumatology, AUVA Trauma Center Salzburg, Salzburg, Austria
,
Josef Schauer
1   Department Traumatology, AUVA Trauma Center Salzburg, Salzburg, Austria
,
Georg Zimmermann
3   Team Biostatistics and Big Medical Data, IDA Lab Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria
4   Research and Innovation Management, Paracelsus Medical University, Salzburg, Austria
,
Christoph Hirnsperger
1   Department Traumatology, AUVA Trauma Center Salzburg, Salzburg, Austria
› Author Affiliations Funding This investigation was done in the AUVA Trauma Center Salzburg, Austria and the institution received no funding or financial support for this investigation.
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Abstract

Background Osteoarthritis at the base of the thumb is the most frequent osteoarthritis of the hand. Trapeziectomy in a broad variety of surgical methods have been proposed to achieve pain reduction and improvement of thumb function. A well-known disadvantage is the long recovery time. Arthroplasty of the thumb carpometacarpal joint is a competing new method for this indication with different revision and complication rates reported.

Purposes The aim of this study is to assess whether there are significant differences in outcome during the first 12 months and time return to work after either, implant of a Maïa joint prosthesis, or trapeziectomy with tendon interposition after Weilby.

Patients and Methods This clinical follow-up study compares the efficacy of total basal joint replacement using the Maïa prosthesis with tendon interposition arthroplasty in 59 thumbs. Clinical, functional, and radiological results at preoperative, 3-, 6-, and 12-month postoperative are presented.

Results We found a significant shorter return to work in the prosthesis group with 4.5 compared with 8.6 weeks. In addition to a significant difference in pain reduction with a better Mayo wrist score in the Maïa group after 3 months. The scores are closer after 6 months and nearly match after 12 months. Measurement of the pinch grip showed a parallel course. A radiological loosening of the cup in two patients was detected after 12 months.

Conclusion Implantation of Maïa prosthesis enables a significant shorter recovery but is associated with the risk of loosening and higher costs.

Level of Evidence Level IV, case–control study.

Keywords

Maïa prosthesis - cementless arthroplasty - thumb carpometacarpal joint arthroplasty - Weilby arthroplasty

Ethical Approval

Ethical approval for this study was obtained from the ethics committee for the hospitals of the AUVA of Austria (Approval number: 02/2020).




Publication History

Received: 18 October 2022

Accepted: 29 May 2023

Article published online:
13 July 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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