Comparative Study of Trapeziectomy with Weilby Suspensionplasty versus Implant Arthroplasty for Thumb Carpometacarpal Joint Arthritis in an Asian Population.

Abstract

Background: This retrospective study compares the outcomes of trapeziectomy and Weilby suspensionplasty procedure versus implant arthroplasty using the TOUCH^® prosthesis for basilar thumb arthritis in an Asian population. Methods: A total of 15 consecutive thumbs in 13 patients were included in this study. Six patients (2 male, 4 female, mean age of 62 years old) underwent trapeziectomy and Weilby suspensionplasty procedure. Seven patients (4 male, 3 female, mean age 63 years old) underwent implant CMCJ arthroplasty using the TOUCH^® prosthesis. Data collected include demographics, severity of arthritis on plain radiographs of the thumb basilar joint, length of follow-up, pre- and postoperative pain levels, Kapandji thumb opposition score, grip and pinch strength and the time taken to return to work. Results: Patients in the trapeziectomy and Weilby suspensionplasty group had a mean follow-up of 4.5 months, while those in the TOUCH^® implant arthroplasty group had a mean follow-up of 14 months. TOUCH^® implant arthroplasty patients showed significantly higher grip strengths at 3 months post-surgery and a shorter return to work. There were no differences in pinch strength at 3 months, pinch or grip strength at 6 months or pain scores. Complications included prolonged scar hypersensitivity in two patients who underwent the Weilby suspensionplasty and a dislocated TOUCH^® implant cup in one patient. Conclusions: Our study suggests that in the short term, CMCJ implant arthroplasty with the TOUCH^® prosthesis produces results comparable to trapeziectomy and Weilby suspensionplasty. Level of Evidence: Level III (Therapeutic).