title: Surgical treatment after a failed trapeziectomy: A case report.
abstract: Several treatment options exist to surgically treat end-stage trapeziometacarpal osteoarthritis. Trapeziectomy is recognized as leading to a mostly acceptable functional outcome. Although rarely encountered, persisting failure of the trapeziectomy is difficult to address. We present a case where several procedures were subsequently performed to treat a failed trapeziectomy condition. First, a trapeziometacarpal prosthesis (Arpe(®), Biomet(®)) was inserted with the two components reversed: the cup in the first metacarpal and the stem in the scaphoid. This prevented normal mobility and resulted in a non-functional, chronically painful joint. Revision arthroplasty was performed with a dual-mobility component (Ebony(®), Stryker(®)), replacing the trapezium to articulate with the first metacarpal and the scaphoid. This restored the first column's length but led to prosthesis instability only 4 months after implantation. Finally, first column arthrodesis with iliac bone graft interposed between the first metacarpal and scaphoid achieved an acceptable outcome.
authors.affiliation: Department of orthopedics and traumatology, university hospital of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: C K
authors.initials: CK
authors.lastname: Goorens
authors.affiliation: Department of orthopedics and traumatology, university hospital of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: D E C
authors.initials: DE
authors.lastname: Van Schaik
authors.affiliation: Department of orthopedics and traumatology, university hospital of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium; Department of orthopedics and traumatology, upper limb unit, AZ Sint-Jan AV Brugge-Oostende, Campus Brugge, Ruddershove 10, 8000 Brugge, Belgium. Electronic address: jean.goubau@azsintjan.be.
authors.forename: J F
authors.initials: JF
authors.lastname: Goubau
mesh_terms: D052737:Carpometacarpal Joints; D005260:Female; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010003:Osteoarthritis / Q000601:surgery*; D051222:Trapezium Bone / Q000601:surgery*; D017211:Treatment Failure
keywords: Arthrodesis; Arthrodèse; Prothèse trapézo-métacarpienne; Trapeziectomy; Trapeziometacarpal prosthesis; Trapézectomie