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Pagpapalit ng Kasukasuan ng Base ng Hinlalaki (Touch)

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Isang yugto-yugong plano ng paggaling pagkatapos ng dual-mobility total joint replacement sa base ng arthritic na hinlalaki (Touch implant), na pinoprotektahan ang bagong kasukasuan sa pamamagitan ng thumb splint sa unang yugto, pagkatapos ay pinapabuti ang opposition at galaw, at pagtatayo ng lakas ng pinch at grip.

Isang guhit-kamay na ilustrasyon ng sendang ng hinlalaki na pinalitan ng maliit na dual-mobility implant.
Pagpapalit ng sendang ng base ng hinlalaki — ang dual-mobility implant ay nagre-resurface sa suot na trapeziometacarpal joint. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ang protokol na ito ay gabay sa iyong paggaling pagkatapos ng pagpapalit ng kasukasuan sa base ng hinlalaki (isang dual-mobility total joint replacement, ang Touch implant) para sa arthritis sa base ng hinlalaki, kay Dr Kieran Hirpara sa Mater Private Hospital Rockhampton. Nagsisimula ito sa iyong home exercise program, sinundan ng istrukturadong klinikal na protokol na isinulat para sa iyong hand therapist; dalhin ang pahinang ito o ang PDF nito sa iyong unang bisita sa therapy upang manatiling koordinado ang iyong rehabilitasyon. Maaaring baguhin ng iyong hand therapist ang plano depende sa pag-unlad ng iyong paggaling. Ang lahat ng iyong paggaling ay pinamumunuan sa pamamagitan ng pormal na hand therapy.

Kung mayroon kang anumang alalahanin tungkol sa iyong sugat pagkatapos ng operasyon, makipag-ugnayan sa mga kwarto. Karaniwang makakatulong na kumuha ng litrato ng sugat at ipadala ito sa pamamagitan ng email para sa pagsusuri.

Ano ang inaasahan

Ang kasukasuan sa base ng iyong hinlalaki (ang trapeziometacarpal, o CMC, kasukasuan) ay kung saan nagtatagpo ang hinlalaki at ang pulso, at ito ay isang napakadalas na lugar ng arthritis. Sa operasyong ito, tinatanggal ang mga suot na ibabaw ng kasukasuan at pinalitan ng isang maliit na artipisyal na kasukasuan: isang dual-mobility implant, isang maliit na bola-at-soket na may karagdagang gumagalaw na ibabaw na nagpapatibay sa kanyang katatagan at pagkakakinis. Itinatapon ang butong trapezium at pinapanatili ang haba ng iyong hinlalaki, kaya’t karaniwang mas mabilis ang paggaling kaysa sa trapeziectomy (ang mas lumang operasyon, na nag-aalis ng isang buto at umaasa sa pagbuo ng scar tissue sa loob ng maraming buwan).

Ang isang maayos na nakaupo na implant ay matatag at kayang magbahagi ng load agad-agad, kaya’t ang hinlalaki ay kailangang protektahan lamang sa maikling panahon imbes na i-immobilize sa loob ng mga linggo. Ang plano ay upang ayusin ang mga malambot na tisyu, pagkatapos ay mabilis na ibalik ang pag-oopposing (pagdikit sa mga daliri) at paggalaw ng iyong hinlalaki, at pagkatapos ay pagbuo ng lakas.

Ang paggaling ay dumadaloy sa tatlong yugto:

  • Una, protektahan (mga unang 2–3 linggo). Isang malambot at makapal na dressing sa unang linggo o higit pa, pagkatapos ay isang thumb splint upang pahingahin ang bagong kasukasuan habang ang sugat at mga malambot na tisyu ay nagse-settle. Pinapanatili mong gumagalaw ang iyong mga daliri, pulso, at ang natitirang bahagi ng kamay.
  • Pagkatapos, gumalaw (mula mga 2–3 hanggang 6 linggo). Labas sa day splint, magsisimula ka ng banayad na aktibong paggalaw (opposition, pagtaas ng hinlalaki, pagbubukas ng web space at pag-ikot) at paggamit ng kamay para sa magaan na pang-araw-araw na gawain.
  • Pagkatapos, palakasin (mula 6 linggo pataas). Kapag ang implant ay nakapag-ugnay na sa buto, magsisimula ang pinch at grip strengthening at unti-unting papalakasin. Patuloy na papalakas ang lakas sa sumunod na 6 hanggang 12 buwan.

Ang isang bagay na dapat igalang sa maagang yugto ay ang bagong kasukasuan ay maaaring lumusob (dislocate) kung ito ay pilitin sa isang ekstremong posisyon bago ang mga tisyu sa paligid nito ay gumaling. Ito ay bihira, at ang maagang plano ay simpleng nakabatay sa hindi pagpilit sa hinlalaki habang ito ay nagse-settle.

Mga Paalala at Limitasyon

  • Suotin ang iyong thumb splint ayon sa utos (isang day splint sa unang 2–3 linggo, pagkatapos ay isang night splint hanggang 6 linggo) at panatilihing naka-splint ang iyong kamay para sa proteksyon hanggang sa itaas ng iyong hand therapist ang pag-unlad ng iyong kalagayan.
  • HUWAG pilitin ang hinirup sa mga matitinding posisyon, at iwasan ang biglaang o hindi komportableng pagkapit sa mga unang linggo; maaaring lumusob ang bagong kasukasuan kung itutulak nang sobra bago ito matatag. Gumalaw lamang hanggang sa komportableng antas.
  • HUWAG gumawa ng malakas na pagpipit, pagkapit, pag-ikot (pagbukas ng mga takip ng lata, susi, gripo) o pag-angat hanggang sa humigit-kumulang 6 linggo; ang pagpapalakas ng kalamnan ay sisimulan lamang kapag nagsimula ito ng iyong hand therapist.
  • Panatilihing gumagalaw ang iyong mga daliri, pulso, at ang natitirang bahagi ng kamay mula sa simula, at panatilihing itaas ang iyong kamay sa maagang yugto upang bawasan ang pamamaga.
  • HUWAG magmaneho habang naka-day splint ka o habang hindi mo komportable at walang sakit ang pagkapit sa manibela.

Para sa pangangalaga sa sugat, pamamaga, at peklat, tingnan ang gabay ng klinika tungkol sa wound care.

Ang iyong mga ehersisyo

Ito ang mga ehersisyo mula sa iyong handout. Simulan lamang ito ayon sa gabay ni Dr. Hirpara at ng iyong hand therapist, at manatili sa loob ng anumang range at limitasyon na ibinigay sa iyo. Ang mga maagang ehersisyo (opposition, pagtaas ng hinlalaki, galaw sa gilid, stretch sa web-space, at banayad na bilog) ay nagbubukas ng galaw ng hinlalaki nang hindi nagpapabigat sa bagong kasukasuan, at magsisimula lamang kapag wala ka na sa iyong day splint. Ang putty at key pinch ay isang huli na ehersisyo para sa pagpapalakas at hindi dapat simulan hanggang sa humigit-kumulang anim na linggo, kapag nagsisimula ito ng iyong hand therapist. Panatilihin ang bawat galaw na banayad at hindi pinipilit sa mga unang linggo, at itigil ang anumang bagay na nagdudulot ng matulis na sakit sa base ng hinlalaki.

Ang iyong klinikal na protokol

Ang natitirang bahagi ng pahinang ito ay ang yugto-yugto na klinikal na protokol para sa rehabilitasyon pagkatapos ng dual-mobility trapeziometacarpal (Touch) total joint replacement. Ang seksyong ito ay dapat ibigay sa iyong hand therapist, at ang bawat yugto ay nagbubukas ng isang paliwanag sa simpleng wikang Ingles kung ano ang nangyayari. Hindi tulad ng trapeziectomy, ang implant ay agad na matatag at nagbabahagi ng karga, kaya't minimal ang immobilisation at maagang naibabalik ang aktibong opposition; ang partikular na maagang panganib ng implant ay dislokasyon kung ipipilit sa extreme na range, kaya't ang unang linggo ay nagpoprotekta laban sa forced/end-range na mga posisyon habang naibabalik ang galaw, pagkatapos ay umaunlad sa loaded strengthening kapag na-osseointegrate na.

Bago ang paggamot, suriin ang operation report at past medical history ng pasyente, at makipag-ugnayan sa treating surgeon tungkol sa implant seating/stability at anumang intra-operative na mga alalahanin. Ang regimen ni Dr. Hirpara ay isang malambot at makapal na dressing para sa 7–10 araw, pagkatapos ay isang thumb spica DAY splint para sa 2–3 linggo, na sinundan ng NIGHT splint na patuloy hanggang 6 linggo (wrist neutral, thumb sa mid palmar abduction, IP free). Ang trapezium ay nananatili at ang haba ng hinlalaki ay napapanatili.

Yugto I — protektahan (linggo 0 hanggang ~2–3)

Ang unang ilang linggo ay para matatag ang mga malambot na tisyu at protektahan ang bagong kasu-kasuan. Ang hinlalaki ay nakapahinga sa isang malambot at makapal na panapos, pagkatapos ay isang day splint na thumb spica, habang ang mga daliri, pulso, at natitirang bahagi ng kamay ay patuloy na gumagalaw. Walang resistadong ehersisyo para sa hinlalaki, at walang pinipilit o sobrang posisyon ng hinlalaki (ang maagang dislokasyon ang partikular na panganib para sa implantong ito).

Para sa iyong hand therapist:

Edukasyon at mga paalala - I-immobilize ang base ng hinlalaki: malambot at makapal na panapos 7–10 araw → thumb spica DAY splint sa loob ng ~2–3 linggo (pulso sa neutral, hinlalaki sa mid palmar abduction, IP joint ay malaya) - Iwasan ang pinipilit o sobrang posisyon ng hinlalaki at biglaang pagkapit: ang dislokasyon ang maagang partikular na panganib para sa implantong ito - Walang resistadong ehersisyo para sa hinlalaki (walang pinch, grip, pag-ikot o pag-angat) - Panatilihing walang karga ang implant; gamitin lamang ang kamay nang walang karga

Pamamahala - Sugat: mga panapos sa operasyon ayon sa utos; monitor para sa impeksyon - Oedema: itaas ang kamay, mabagal na pagpump ng kamay, yelo kung kinakailangan - Mga ehersisyo: aktibong ROM ng IP joint ng hinlalaki, mga daliri, at pulso; panatilihing buo ang galaw ng buong kamay; walang aktibong CMC/opposition work pa, walang pagkarga

Mga pamantayan para makapagpatuloy - Matatag na sugat; komportable; lumabas sa day splint sa paligid na 2–3 linggo para sa aktibong galaw

Yugto II — aktibong galaw sa loob ng night splint (linggo ~2–3 hanggang 6)

Mula sa mga dalawa hanggang tatlong linggo, tinatanggal ang day splint at nagsisimula ang banayad na aktibong galaw ng hinlalaki: opposition (isang Kapandji progression), palmar at radial abduction, banayad na circumduction, at mobilisasyon ng web-space. Ang night splint ay patuloy na ginagamit hanggang anim na linggo. Pinapayuhan ang magaan na pang-araw-araw na paggamit; ang mabigat na hawak (grip) at pinch ay patuloy na ipinagbabawal.

Para sa iyong hand therapist:

Mga Pagsusuri - Aktibong opposition ng hinlalaki (Kapandji score), palmar/radial abduction, lapad ng web-space; sakit at pamamaga; pagsusuri sa sugat/gigilid

Edukasyon at mga paalala - Labas sa day splint; patuloy ang NIGHT splint hanggang 6 linggo - Aktibong walang resistensyang galaw ng hinlalaki lamang: walang mabigat na hawak o pinch bago ang 6 linggo - Panatilihin ang galaw sa loob ng kaginhawaan; iwasan ang pagpilit sa end-range

Pamamahala - Mga ehersisyo: aktibong walang resistensyang opposition (Kapandji progression), palmar at radial abduction, banayad na circumduction, mobilisasyon ng web-space; magaan na pang-araw-araw na functional na paggamit ng kamay; simulan ang scar massage kapag gumaling na ang sugat

Mga Kriteryo para mag-proceed - Mabuting aktibong opposition na naibalik; gumaling na ang sugat; walang sakit na walang resistensyang galaw sa mga humigit-kumulang 6 linggo

Yugto III — mag-load at palakasin (ika-6 linggo pataas)

Mula sa humigit-kumulang anim na linggo, ang implant ay osseointegrated na at maaaring mag-load. Nagsisimula ang pagpapalakas ng pinch at grip (putty pinch, key at tip pinch, pagpapalakas ng opposition) at unti-unti itong pinapalalakas. Patuloy na nagsasakripisyo ang lakas sa susunod na 6 hanggang 12 buwan.

Para sa iyong hand therapist:

Mga Pagsusuri - Lakas ng key/tip pinch at grip kumpara sa kabilang panig; opposition; tugon sa sakit/pamamaga sa pag-load; functional at work-specific na pagsusuri kung angkop

Edukasyon at mga paalala - Simulan ang progressive pinch at grip strengthening mula sa ika-6 linggo; unti-unting dagdagan ang load - Inaasahan na nagsasakripisyo ang lakas sa loob ng 6–12 buwan; payuhan ang pasyenteng maging pasensyoso sa mas mabigat na pag-load

Pamamahala - Mga ehersisyo: putty pinch, key/tip pinch, pagpapalakas ng opposition, progressive resistance; pagpapalakas ng grip; patuloy na anumang natitirang mobility at trabaho sa peklat - Isaalang-alang ang discharge kapag functional na ang lakas at nakamit na ang angkop na pagbabalik ng function - Isaalang-alang ang referral pabalik sa treating doctor kung huminto ang recovery o may mababang resulta

Mga pamantayan para sa discharge - Functional, halos symmetrical na pinch at grip; walang sakit sa pang-araw-araw at work-specific na paggamit

Pagbabalik sa trabaho at gawain

Ang magaan na paggamit ng kamay sa pang-araw-araw na gawain (pagkain, pagsulat, magaan na pag-aalaga sa sarili) ay inirerekomenda sa loob ng limitadong kahirapan, simula noong maagang yugto, basta’t hindi ito kasama ang pagpilit sa hinlalaki o malakas na pagpipitak at paghawak. Dahil hindi ka dapat magmaneho habang naka-splint sa araw o habang hindi mo komportableng hawakan ang manibela, magplano ng tulong sa transportasyon sa unang ilang linggo. Karaniwang muling magsisimula ang pagmamaneho kapag wala ka nang naka-splint sa araw at kayang hawakan ang manibela nang walang sakit, karaniwang sa loob ng dalawa hanggang apat na linggo, ayon sa pagpapatunay ni Dr. Hirpara.

Ang opisina at magaan na trabaho ay karaniwang posibleng gawin sa loob ng dalawa hanggang apat na linggo; ang manual at mabigat na trabaho ay inaantay hanggang humigit-kumulang anim na linggo, at dahan-dahang binubuo, dahil ang malakas na pagpipitak at paghawak ay nagsisimula lamang sa anim na linggo. Ang lakas ay patuloy na umaayos sa loob ng 6 hanggang 12 buwan, kaya ang mas mabigat at mas demanding na mga gawain ay ibabalik nang unahan-hanap, imbes na sabay-sabay, batay sa kung paano tumutugon ang iyong hinlalaki, kasama si Dr. Hirpara at ang iyong hand therapist, imbes na ang kalendaryo lamang.

Pagkatapos ng iyong protocol

Ang protocol na ito ay nagtatrabaho kasama ng pangkalahatang payo para sa paggaling ng klinika; tingnan ang pamamahala ng post-operative na pananakit, pag-aalaga sa sugat at pamamahala ng peklat. Ang naka-phased na plano sa itaas ay sumasalamin sa inilathala na gabay sa rehabilitasyon pagkatapos ng dual-mobility thumb base joint replacement, at ang iyong patuloy na paggaling ay indibidwal na pinamumunuan ni Dr. Hirpara at ng iyong hand therapist ayon sa pag-unlad ng iyong hinirap.

Reviewed by Dr Kieran Hirpara · 20 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Thumb Base Joint Replacement (Touch) — Procedure Outcomes & Post-operative Rehabilitation (Dual-mobility TMC/CMC Total Joint Arthroplasty)

Topic scope: post-operative rehabilitation after a dual-mobility total joint replacement of the trapeziometacarpal (thumb base / CMC) joint for advanced thumb base osteoarthritis — the Touch implant. Unlike trapeziectomy, the trapezium is retained and thumb length preserved, and a correctly seated dual-mobility implant is immediately stable and load-sharing. The rehab is therefore a minimal-immobilisation, early-motion pathway: protect briefly against the implant-specific early dislocation risk, restore opposition within the first month, then load.

Defining principle of the rehab here: a trapeziectomy relies on a scar/haematoma "spacer" forming where the bone was removed, which takes roughly 12 months to mature — so rehab is slow by necessity. A dual-mobility thumb base replacement instead provides an immediately stable, load-sharing artificial joint, so immobilisation can be minimal, opposition is restored within the first month, and recovery is faster than trapeziectomy. The dual-mobility cup specifically reduces the early dislocation risk that drove longer immobilisation with older single-mobility implants. The one deliberate early restraint is therefore avoidance of forced/extreme thumb positions (the implant-specific dislocation risk) for the first few weeks, after which loaded pinch/grip strengthening begins. This is a newer implant: the evidence base is short-to-mid-term and low-to-moderate level, and rehab regimens are under-reported and not standardised.

A. PROCEDURE OUTCOMES (dual-mobility Touch TMC arthroplasty)

Dual-mobility total joint replacement of the thumb base is a comparatively new alternative to trapeziectomy for advanced trapeziometacarpal osteoarthritis. Early- to mid-term series report high implant survival and good restoration of pinch and function, with the principal trade-off being a higher complication/revision profile than the well-established trapeziectomy — though the dual-mobility design improves on the dislocation rate of earlier single-mobility implants.

  • High short-to-mid-term implant survival and good function. A Touch-specific series reported 96% implant survival at 2 years with high key-pinch strength; the main adverse events were soft-tissue complications (de Quervain-type tenosynovitis, trigger digit) rather than implant failure [Herren 2023]. A 150-patient dual-mobility cohort similarly reports early normalisation of function. Moderate (case series / retrospective cohort).
  • Faster recovery than trapeziectomy because the joint is immediately stable. Because the implant is load-sharing from the outset, the thumb is only briefly immobilised, patients return to near-normal activity early, and formal therapy may not always be required — contrasting with the ~12-month maturation of a trapeziectomy spacer [Duerinckx & Verstreken 2022]. Moderate (narrative review / cohort).
  • Opposition and pinch/grip recover well. Using the MOOVIS dual-mobility implant, the Kapandji opposition score improved from 7 to 10 with improved pinch and grip [Dreant 2018]. Moderate (cohort).
  • The dual-mobility design reduces dislocation. The extra articulation lowers the early dislocation risk that limited older single-mobility prostheses, supporting earlier mobilisation [Tchurukdichian 2019; Martins 2020]. Moderate (cohort / mechanistic).
  • Lower reoperation than ball-and-socket designs; persistent revision risk overall. A network meta-analysis found dual-mobility implants had lower reoperation than ball-and-socket designs, with TOUCH reoperation around 1.0% [Burnett 2026 NMA]. Reported outcomes continue to evolve in ongoing reviews [Tosti & Duerinckx 2026]. Moderate (NMA of mostly observational data).
  • Registry-level work-absence benchmark. Swedish registry data give a sense of real-world recovery: sick leave of roughly 94 days for men and 109 days for women — a benchmark to set realistic return-to-work expectations rather than a target. Moderate (registry).

B. REHABILITATION / THERAPY EVIDENCE

The central rehab questions are (1) how long to immobilise, and (2) when to start motion and loading. Because the implant is immediately stable, the modern answer is minimal immobilisation with early active opposition — but the literature is explicit that there is no consensus and wide variation between centres, and that rehab protocols are under-reported.

  • Minimal immobilisation is justified by immediate stability. A correctly seated dual-mobility implant is stable and load-sharing, so prolonged casting is unnecessary; the thumb is briefly protected, then mobilised early, with opposition typically back within the first month [Duerinckx & Verstreken 2022]. Moderate (review).
  • No standardised regimen — wide variation in immobilisation and motion timing. A dedicated review of immobilisation and rehabilitation after thumb-base arthroplasty found reported immobilisation ranging from 2 to 12 weeks and active range-of-motion commencing anywhere from 1 to 6 weeks, with no consensus across studies [Barrett 2022]. This is the key caveat for any protocol: the timings are a defensible, surgeon-confirmed plan, not a trial-derived standard. Moderate (systematic review of heterogeneous protocols).
  • Early opposition recovery is achievable and is the functional priority. Improvement of the Kapandji opposition score (7→10) demonstrates that active opposition is the early rehab target and is realistically attainable in the first weeks-to-months [Dreant 2018]. Moderate (cohort).
  • The early restraint is dislocation avoidance, not protected healing. The dual-mobility design reduces but does not abolish early dislocation; the practical implication is to avoid forced/extreme thumb positions in the first weeks rather than to immobilise for prolonged periods [Tchurukdichian 2019; Martins 2020]. Moderate / mechanistic.

Recovery trajectory (expected, evidence-anchored)

Phase Window Restraint Hand use / therapy focus Strength / load Notes
I — Protect Week 0 to ~2–3 Soft bulky dressing 7–10 d → thumb spica DAY splint Keep IP/MCP/digits/wrist moving; oedema control; avoid forced/extreme thumb positions No resisted thumb work Early dislocation is the implant-specific risk; minimal immobilisation because the implant is immediately stable
II — Active motion Week ~2–3 to 6 NIGHT splint to 6 wk Out of day splint; active unresisted opposition (Kapandji), palmar + radial abduction, gentle circumduction, web-space work; light everyday use; scar massage once healed Still no heavy grip/pinch Opposition typically restored within the first month; faster than trapeziectomy
III — Load / strengthen Week 6+ Restrictions lifted Progress pinch/grip-specific loading and task use Pinch + grip strengthening from 6 wk (putty, key/tip pinch); full weight-bearing ~6 wk Strength matures over 6–12 months; return to heavy/manual work staged across this window

(Phase windows reflect KH-confirmed parameters and are consistent with the wide ranges reported in the literature; they are typical guides, not trial-derived deadlines — see Barrett 2022.)

C. KEY CONTROVERSIES / EVIDENCE QUALITY

  1. Replacement vs trapeziectomy. Dual-mobility replacement restores the joint and gives a faster functional return (immediate stability, opposition back within a month) versus the ~12-month maturation of a trapeziectomy spacer, but at the cost of a higher complication and revision rate and a shorter evidence track record. Trapeziectomy remains the well-established, lower-risk benchmark. Moderate; trade-off, not a clear winner.
  2. How long to immobilise / when to start motion. No consensus — reported immobilisation spans 2–12 weeks and AROM start 1–6 weeks [Barrett 2022]. This page's day-splint-2–3-weeks → night-splint-to-6-weeks → strengthen-from-6-weeks plan is a defensible, surgeon-confirmed regimen within that reported range, not a proven standard. Weak–moderate.
  3. Dislocation risk. The dual-mobility cup reduces the early dislocation that limited older single-mobility implants, but the risk is not zero in the first weeks — hence the early forced/extreme-position restraint [Tchurukdichian 2019; Martins 2020]. Moderate / mechanistic.
  4. Complication profile. Soft-tissue complications (de Quervain-type tenosynovitis, trigger digit) are the commonest early issues rather than implant failure [Herren 2023]; reoperation is low for dual-mobility (TOUCH ~1.0%) and lower than ball-and-socket designs [Burnett 2026 NMA]. Moderate.
  5. Maturity of the evidence. This is a newer implant: outcomes are short-to-mid-term, evidence is low-to-moderate level (case series, retrospective cohorts, registry and NMA of mostly observational data), and rehabilitation is under-reported and not standardised. Tone should be appropriately cautious. Evidence base still maturing.

D. EVIDENCE STRENGTH FLAGS (summary)

  • MODERATE (cohort / registry / NMA of observational data): high short-to-mid-term implant survival (96% at 2 yr, Touch) with good key-pinch; Kapandji opposition 7→10; dual-mobility lower reoperation than ball-and-socket (TOUCH ~1.0%); registry sick-leave benchmark (~94 d men / 109 d women); faster functional return than trapeziectomy.
  • MODERATE (systematic review of heterogeneous protocols): no consensus on rehab — immobilisation 2–12 weeks, AROM start 1–6 weeks (Barrett 2022).
  • WEAK / CONSENSUS: the specific immobilisation-then-early-opposition-then-strengthen phase timings (surgeon-confirmed, within the reported range; not trial-derived); the dislocation-avoidance rationale (mechanistic).
  • CAVEAT: newer implant — short-to-mid-term, low-to-moderate-level evidence; higher complication/revision rates than trapeziectomy persist; rehab under-reported.

CITATIONS

RAG corpus (180,000+ Orthopaedic articles)

  • Duerinckx J, Verstreken F. Dual mobility prosthesis for trapeziometacarpal joint arthritis. EFORT Open Rev. 2022. DOI: 10.1530/eor-22-0027
  • Herren DB, et al. Trapeziometacarpal joint replacement with the Touch prosthesis: two-year results. J Hand Surg (Eur Vol). 2023. DOI: 10.1177/17531934231179581
  • Dreant N, et al. Trapeziometacarpal arthroplasty with the dual-mobility MOOVIS prosthesis. Hand (NY). 2018. DOI: 10.1177/1558944718797341
  • Tchurukdichian A, et al. Dual-mobility implant reduces the dislocation risk in trapeziometacarpal arthroplasty. Hand (NY). 2019. DOI: 10.1177/1558944719855690
  • Martins A, et al. Dual-mobility trapeziometacarpal prosthesis. J Hand Surg (Eur Vol). 2020. DOI: 10.1177/1753193420901435
  • Barrett H, et al. Immobilization and rehabilitation after trapeziometacarpal joint arthroplasty: a review. J Hand Surg Glob Online. 2022. DOI: 10.1016/j.jhsg.2022.05.011
  • Tosti R, Duerinckx J. Trapeziometacarpal total joint arthroplasty: current concepts. J Hand Surg Am. 2026. DOI: 10.1016/j.jhsa.2026.01.003
  • Burnett K, et al. Implant designs for trapeziometacarpal arthroplasty: a network meta-analysis of reoperation. J Hand Surg Am. 2026. DOI: 10.1016/j.jhsa.2025.12.011

Thumb base arthroplasty literature (URLs)

  • Herren DB, et al. TOUCH trapeziometacarpal prosthesis — two-year results. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12098211/
  • Dual-mobility trapeziometacarpal arthroplasty — 150-patient cohort. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12662895/
  • TOUCH prosthesis case series. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC8470025/
  • KeriMedical — TOUCH thumb base prosthesis patient information. https://www.kerimedical.com/en/patients/

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Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.