title: Trapeziectomy or revision into a cemented polyethylene cup in failed trapeziometacarpal total joint arthroplasty.
abstract: OBJECTIVE
  Total joint replacement as treatment of osteoarthritis of the trapeziometacarpal joint may lead to excellent short-term results, but also with a high risk of failure of the trapezium component. The aim of this study was to compare revision using trapeziectomy with a revision into a cemented trapezium cup.
  
  
  METHODS
  Thirty-four patients with a mean follow-up time of 47 months were included in a case control study with 17 hands revised with a cemented cup and 21 trapeziectomy.
  
  
  RESULTS
  At follow-up, no significant difference was found in self-reported outcome, with pain at rest or activity and in grip strength comparing patients revised using trapeziectomy with patients revised with insertion of a new cup. There was, however, a high risk of re-revision in patients treated with insertion of a new cup and at the follow-up 4/17 cups had been re-revised and 5/17 cups had radiological signs of implant loosening.
  
  
  CONCLUSIONS
  IT was found that trapeziectomy should be the standard salvage procedure after a failed trapezium implant and revision of cup loosening with a cemented cup has an unacceptable failure rate.
authors.affiliation: a Department of Orthopaedic Surgery, Section of Hand Surgery , Regional Hospital Holstebro, Aarhus University , Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Knak
authors.affiliation: a Department of Orthopaedic Surgery, Section of Hand Surgery , Regional Hospital Holstebro, Aarhus University , Denmark.
authors.forename: Torben B
authors.initials: TB
authors.lastname: Hansen
mesh_terms: D000368:Aged; D050806:Arthroplasty, Replacement, Finger / Q000009:adverse effects*; D001843:Bone Cements; D016022:Case-Control Studies; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D016879:Salvage Therapy; D051222:Trapezium Bone / Q000601:surgery*
chemical_list: D001843:Bone Cements
keywords: Trapeziometacarpal osteoarthritis; total joint arthroplasty revision; trapeziectomy; trapeziometacarpal total joint arthroplasty