title: [Replacement of the thumb carpometacarpal joint : Current importance of endoprosthetics for operative treatment of rhizarthrosis].
abstract: The role of joint replacement in the treatment of osteoarthritis of the thumb carpometacarpal joint is a subject of considerable controversy in the current literature. In German-speaking countries this technique is used much less frequently than resection procedures. Aseptic loosening of the prosthesis is believed to be the major cause of the high failure rates reported for cemented and uncemented types of implants. In this study the different implant designs were evaluated on the basis of the results reported in the international literature. There are only a few studies that cover relatively long follow-up periods and provide convincing results for thumb carpometacarpal joint prostheses in terms of implant survival and function. Aseptic loosening is reported to be the major cause with failure rates of 50 % or more. Although a Norwegian study reported high 5 and 10-year survival rates for various thumb carpometacarpal joint prostheses according to the Norwegian arthroplasty registry, it did not recommend the widespread use of thumb carpometacarpal joint replacement at the present time. In our opinion, joint replacement may be considered as a possible treatment option for advanced osteoarthritis of the thumb carpometacarpal joint but it should not always be recommended because long-term results are inconsistent and similar functional outcomes have been reported for alternative surgical techniques, such as resection arthroplasty.
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Verbrennungsmedizin, Abtlg. XIV, Bundeswehrzentralkrankenhaus, Rübenacher Straße 170, 56072, Koblenz, Deutschland. ErwinKollig@Bundeswehr.org.
authors.forename: E
authors.initials: E
authors.lastname: Kollig
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Verbrennungsmedizin, Abtlg. XIV, Bundeswehrzentralkrankenhaus, Rübenacher Straße 170, 56072, Koblenz, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Bieler
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Verbrennungsmedizin, Abtlg. XIV, Bundeswehrzentralkrankenhaus, Rübenacher Straße 170, 56072, Koblenz, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Franke
mesh_terms: D052737:Carpometacarpal Joints / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D007103:Immobilization / Q000379:methods*; D007593:Joint Instability / Q000209:etiology* / Q000517:prevention & control; D007595:Joint Prosthesis / Q000009:adverse effects*; D010003:Osteoarthritis / Q000175:diagnosis / Q000601:surgery*; D011475:Prosthesis Failure; D013933:Thumb / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthroplasty; Indications; Joint replacement; Osteoarthritis; Thumb carpometacarpal joint