Efficacité de la prothèse trapézo-métacarpienne Touch® dans le traitement de la rhizarthrose : étude rétrospective à 5 ans

• Published in: Hand surgery and rehabilitation 2024-12, Vol.43 (6)
• Main Authors: Essid, Leila, Boudousq, Elise, Guillier, David, Zwetyenga, Narcisse, Tchurukdichian, Alain
• Format: Article
• Language: fre
• ISSN: 2468-1229
• DOI: 10.1016/j.hansur.2024.101821

Trapezometacarpal Osteoarthritis or rhizarthrosis, is a frequent osteoarthrosis of the base of the thumb. The total joint replacement represents an interesting surgical option for its treatment. The double-mobility Touch® prosthesis is available for several years and only few studies have been published to evaluate the safety and efficiency of this prosthesis in the long term. The objective of this study is to describe the outcomes of the Touch prosthesis for a minimal 5 years follow-up. Patients who received a Touch prosthesis in the two investigational centers between March 2016 and July 2018, and with a 5 years follow up, were included in this retrospective and non-comparative study. From 111 patients screened, 74 patients were included of which 8 had surgery at both sides. The mean age at the time of surgery was 62.4 (± 7.3) years. 62 (83.8%) were women and 51.2% of the patients had their dominant hand operated. The pain (VAS), Grip and Key pinch were significantly improved at five years follow-up. The quick DASH decreased from 55.1 to 14.6. The Kapandji opposition and retropulsion, the MCP active mobility flexion and extension improved. 91.3% of the patients are satisfied. 19 (23.2%) adverse events were minor and 8 (9.8%) were major. The most common adverse event was temporary dysesthesia representing 8.6%. 5 (6.1%) prostheses were revised and 1 (1.2%) was removed which lead to an implant survey of 92.7% at 5 years for all type of events. However, the survival rate is 97.6% if only device or procedure related events are counted. At five years of the 82 prosthesis, 92.7% are still placed, 4.9% had a component change and only 2.4% were converted to trapeziectomy. The results show a persistence of clinical benefit at middle term with high satisfaction of patients. They regained and kept a strength thumb. 19 (23.2%) adverse events linked to the device procedure needed none or minor treatment and could all be resolved easily. The 5 (6.1%) major complications linked to the device or procedure were also resolved without difficulties. Of the six prostheses failure, only two were due to the device. The double-mobility prosthesis is a reliable treatment of the CMC joint osteoarthrosis at middle term.