Efficacy and Safety of Different Trapezium Implants for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review and Meta-Analysis.

Abstract

Background: The trapeziometacarpal joint (TMCJ) is the most common hand joint affected by osteoarthritis (OA), and trapezium implant arthroplasty is a potential treatment for recalcitrant OA. This meta-analysis aimed to investigate the efficacy and safety of various trapezium implants as an interventional option for TMCJ OA. Methods: Web of Science, PubMed, Scopus, Google Scholar, and Cochrane library databases were searched for relevant studies up to May 28, 2022. Preferred Reported Items for Systematic Review and Meta-Analysis guidelines were adhered to, and the protocol was registered in PROSPERO. The methodological quality was assessed by National Heart, Lung, and Blood Institute tools for observational studies and the Cochrane risk of bias tool. Subgroup analyses were performed on different replacement implants; the analysis was done using Open Meta-Analyst software and P values <.05 were considered statistically significant. Results: A total of 123 studies comprising 5752 patients were included. Total joint replacement (TJR) implants demonstrate greater significant improvements in visual analogue scale pain scores postoperatively. Interposition with partial trapezial resection implants were associated with highest grip strength and highest reduction in the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Revision rates were highest in TJR (12.3%) and lowest in interposition with partial trapezial resection (6.2%). Conclusion: Total joint replacement and interposition with partial trapezial resection implants improve pain score, grip strength, and DASH scores more than other implant options. Future studies should focus on high-quality randomized clinical trials comparing different implants to accumulate higher quality evidence and more reliable conclusions.