Patients › Hand

Touch thumb arthroplasty

PDF Evidence Consent

Updated Oct 2026

A Touch thumb replacement resurfaces the joint at the base of the thumb, the joint that wears out in basal thumb arthritis, to restore comfortable pinch. Kieran Hirpara 4.0

Why this operation has been suggested

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. At your appointment we take a history, examine your hand, and arrange imaging if it is needed to confirm the diagnosis.

Wear-and-tear arthritis at the base of the thumb is a common cause of pain and weakness. It can make pinching, gripping and turning a key hard to do. We usually try non-operative care first, such as changing how you use your hand, hand therapy and splinting. Surgery is considered when those measures have not given you enough improvement.

This operation, a thumb joint replacement, replaces the worn joint at the base of your thumb with an artificial implant. It is typically offered to people with arthritis confined to that joint whose pain has not settled with non-operative care. We may have suggested it for you because it aims to relieve pain and restore movement, strength and stability so you can use your thumb with confidence. Most Touch implants are still in place at 2 years, with 96% implant survival reported. Whether this operation suits you is a decision we make together.

Before the operation

In the weeks before surgery we confirm the plan with imaging of your thumb, such as an X-ray, MRI or ultrasound. These pictures show the worn joint and help us plan the replacement. You will get clear instructions from our team about preparing. You will need to stop eating and drinking seven hours before your operation. We ask for seven rather than six so we can bring you forward if the theatre list runs early. Some medicines need to be paused, and we will tell you which ones and when. Bring a list of your current medications. Arrange for someone to drive you home afterwards. Wear loose, comfortable clothing. If you have other medical conditions, you may need blood tests or a review with the anaesthetist.

On the day

On the day of your operation you come to the hospital's surgical admissions unit. There you are checked in and prepared for theatre. You will meet the anaesthetist, the doctor who looks after your sleep and comfort during surgery. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief; the anaesthetist decides on the day based on your individual circumstances.

You are then taken into the operating theatre, where the operation is performed. Afterwards you wake up in the recovery area, where nurses watch over you while the anaesthetic wears off. Once you are stable you either go to the ward or go home, depending on the procedure and your recovery.

What the operation involves

Your surgeon makes a single cut over the base of your thumb to reach the worn joint. The damaged joint surfaces are removed and replaced with artificial parts: a small stem placed in the thumb bone and a cup fitted into the small bone next to it. The new parts are designed to move against each other like a healthy joint, so you can pinch and grip again.

The aim is to keep your thumb at its natural length and line-up, which helps the thumb look and work as close to normal as possible. Because the joint is replaced rather than removed, the muscles and tendons that move your thumb do not have to work as hard to produce a pinch.

When the replacement is in place, your surgeon closes the cut with stitches and applies a dressing. You will wake up with your thumb wrapped up, and the dressing stays on for about 10 days.

Afterwards, a hand therapist guides your recovery. They show you how to move and use your thumb as it heals, and they guide when and how much to lift. Keeping heavy loads off the new joint helps it last.

After the operation

Most patients stay one night in hospital after this operation, though some are able to go home the same day. You wake up in the recovery area, then move to the ward. Nurses check your pain and give you medicine to keep it comfortable. Your thumb will be wrapped in dressings and supported in a splint. Keep your hand raised on pillows when resting; this helps settle swelling. You can get up and walk around the ward, and you will use your other hand for most tasks. Please arrange for someone to stay with you for the first 24 hours at home. We leave the dressing on for about 10 days; please do not take it off before then unless we tell you to. We change or remove it when we see you.

Recovery

For the first few days your thumb will be sore and swollen. Keeping your hand raised on pillows helps the swelling settle. Simple pain medicine, taken as directed, keeps you comfortable while the worst passes.

You will go home with your thumb in a splint, and the dressing stays on for about 10 days. Hand therapy after surgery is with Ruby Doolan at Extend Rehabilitation. Ruby is a hand therapist: she shows you gentle exercises that keep your fingers moving while the new joint heals, and she makes any splint you need as your thumb recovers. She also guides when and how much to lift, because keeping heavy loads off the new joint helps it last.

Day to day, you will use your other hand for most tasks at first. You cannot drive while the splint is on, because it stops you gripping the wheel safely. Once the splint is removed and your surgeon clears you, driving can begin; see our page on Driving after upper-limb surgery. As the swelling settles and movement returns, you will start using your thumb for light daily tasks, then build up to gripping and pinching without pain.

Recovery varies from person to person. Your timeline may differ, and your surgeon and hand therapist will guide you at each step.

What can go wrong

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

The new joint parts can sometimes loosen. This usually feels like a deep, aching pain at the base of your thumb that returns or worsens after a period of relief. If your thumb becomes painful again weeks or months after surgery, call the clinic so we can arrange imaging and see what is happening.

The joint can also dislocate, meaning the new parts slip out of place. You would feel a sudden clunk, followed by pain and a thumb that will not move normally. Call the clinic straight away if this happens.

A fracture of one of the small bones around the new joint can happen during or after surgery. This feels like sharp pain and swelling that is much worse than expected. Call the clinic so we can check it.

Nerves near the thumb can be irritated or bruised. You might notice tingling, pins and needles, or numbness on the back of your thumb. Numbness and weakness in the first 24 hours after a nerve block are expected. Once the block has worn off, call the clinic if numbness stays or you cannot move your thumb or fingers.

Infection is uncommon but serious. Call the clinic the same day if you have a fever, redness spreading out from the wound, or fluid or pus leaking from it. Go to the emergency department if your thumb turns pale, cold, white, blue or dark, as this can be a circulation problem.

Some patients develop ongoing pain and sensitivity in the hand after surgery, sometimes with swelling and changes in skin colour or temperature. If pain keeps getting worse despite your pain medicines, call the clinic the same day.

If the new joint does not work out, further surgery is sometimes needed. This can mean fixing or replacing the implant, or converting to a different operation that removes the worn joint and cushions the space with your own tissue. We will talk through the options with you if this ever arises.

The complications table on this page lists typical rates if you want the specifics.

When to call us

Most problems show up early, and we would rather hear about them soon. Call the clinic the same day if you have a fever, redness spreading out from the wound, or fluid or pus leaking from it, or if pain keeps getting worse despite your pain medicines. Call us if numbness stays or you cannot move your thumb or fingers once the nerve block has worn off, about 24 hours after surgery. Go to the emergency department if you have swelling or pain in your calf, shortness of breath or chest pain, as these can be signs of a blood clot. The same applies if your thumb turns pale, cold, white, blue or dark. If you cannot reach the clinic out of hours or on a weekend, go to your nearest emergency department.

Where to read more about the condition

This page is about the operation itself. The condition it treats, including what the evidence shows about when surgery helps and when it does not, is covered in more detail on the Basal Thumb Arthritis page.

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Reviewed by khirpara · 20 May 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

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

• The Touch® trapeziometacarpal joint arthroplasty demonstrated a 96% implant survival rate at 2 years [4].
• The Touch® prosthesis is recommended as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis [4].
• The Touch1 prosthesis is a safe and stable implant providing good satisfaction and very good functional scores [7].
• Patients using the Touch1 prosthesis experience a fast return to work and leisure activity [7].
• Trapeziometacarpal prosthesis enhances function, thumb length, and patient recovery [2].
• Total joint arthroplasty for primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility, and high patient satisfaction [10].
• The MAÏA trapeziometacarpal prosthesis is a reliable long-term surgical procedure that improves overall function beyond 10 years [23].
• The MAÏA TMC total joint arthroplasty provides very good results for pain relief, strength, mobility, and restoration of thumb length [13].
• The MAÏA TMC total joint arthroplasty provides correction of most thumb z-deformities [13].
• The Elektra prosthesis had a revision rate of 44% after 72 months [1].
• The Elektra prosthesis is not recommended due to poor outcomes observed after only 2 years [8].
• The main complication for the Elektra prosthesis was loosening, with a rate never dropping below 17% at 4 years [9].
• The Moovis prosthesis is recommended for the treatment of advanced trapeziometacarpal osteoarthritis in patients without too many manual constraints [5].
• Dual mobility arthroplasty for thumb CMC joint osteoarthritis is a satisfactory solution with good functional results and absence of early and middle term dislocations [12].
• The Ivory arthroplasty is a reliable option for treating advanced trapeziometacarpal osteoarthritis, providing important improvement in overall function and pain reduction [15].
• Not every complication associated with the Ivory prosthesis requires surgical revision [14].
• Correct implant position leads to reliable medium-term results after trapeziometacarpal joint arthroplasty [11].
• Limiting the magnitude of thumb loads after arthroplasty may contribute positively to the longevity of the procedure [3].
• Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis is not sufficiently reliable to be a routine solution for surgical revision of failed TMC arthroplasty or trapeziectomy [21].
• Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis should be used with caution, primarily as a salvage solution if no safer alternative is available [21].
• The Touch® prosthesis is compatible with the Ivory® trapeziometacarpal prosthesis stem during revision surgery [16].
• If the trial neck does not align with the centre of the trapezium, the cup position should be dictated by the neck to represent the new centre of rotation [17].

Anatomy & Pathophysiology

Bony Anatomy

• The skeleton of the hand consists of 27 bones, of which 19 are long bones [30].
• The radial ray or first ray is the shortest and is made up of only three bones: a metacarpal and two phalanges [30].
• The trapezium is clearly angled out in front of the carpal plane so that the first metacarpal makes an angle of about 45 degrees with the second metacarpal in the sagittal plane [30].
• The thumb metacarpal is independent and articulates with the trapezium [36].
• The base of each metacarpal articulates with the distal row of the carpus [30].
• The thumb ray continues the external column of the carpus formed by the scaphoid and trapezium [30].

Joint Mechanics & Kinematics

• The trapeziometacarpal joint has a saddle shape in opposing planes of the articular surfaces [30].
• The first metacarpal makes an angle of about 45 degrees with the second metacarpal in the sagittal plane, which explains the gap between the first ray and the palm [30].
• The thumb ray is more mobile, shorter, and more proximal than the other rays, allowing it to project in front of the plane of the palm to oppose itself to the other four rays [30].
• The wrist has three axes of movement, permitting the hand to be positioned in any spatial configuration [30].
• The combined movements of the wrist and forearm place the hand in a position for grasping [31].
• The thumb has a more proximal and lateral position, allowing movement inward and outward from the palm [31].

Musculature & Tendon Anatomy

• The first (most radial) extensor compartment contains the abductor pollicis longus and the extensor pollicis brevis [29].
• The abductor pollicis longus inserts at the base of the thumb metacarpal and radially abducts the thumb [29].
• The extensor pollicis brevis inserts on the dorsum of the proximal aspect of the proximal phalanx of the thumb and actively extends the metacarpophalangeal joint of the thumb [29].
• The extensor pollicis longus runs longitudinally down the forearm through the third compartment and turns abruptly radialward about Lister tubercle [29].
• The extensor pollicis longus inserts on the distal phalanx and provides forceful extension of the thumb interphalangeal joint [29].
• The flexor pollicis longus originates from two heads: a radial head from the proximal radius and interosseous membrane, and an accessory head from the coronoid process of the ulna and medial epicondyle of the humerus [40].
• The flexor pollicis longus inserts into the proximal base of the thumb distal phalanx and is innervated by the anterior interosseous branch of the median nerve [40].
• The flexor pollicis longus flexes both the interphalangeal and metacarpophalangeal joints of the thumb [40].
• The tenosynovial sheath of the flexor pollicis longus is continuous with the radial bursa [40].

Vascular Anatomy

• The "princeps pollicis" artery, a terminal branch of the radial artery, crosses the first intermetacarpal space and runs along the ulnar side of the first metacarpal bone [37].
• The princeps pollicis artery emerges onto the subcutaneous palmar tissue at the level of the cutaneous flexion crease of the metacarpophalangeal joint [37].
• The princeps pollicis artery divides into two terminal rami, the collateral palmar arteries of the thumb, which run along the digital tunnel symmetrically [37].
• An arcade located deep in the flexor tendon joins together the two palmar arteries at the level of the distal metaphysis of the first phalanx [37].
• The dorsal arteries of the thumb originate from terminal branches of the radial artery at the level of the anatomical snuff-box [37].
• The posterior area of the thumb is vascularized by two arteries which originate from the palmar arteries at the level of the first metacarpal [37].

Soft Tissue & Skin Anatomy

• The superficial palmar fascia covers a triangular area of the central palm, with no central band for the thumb [43].
• The dorsal skin of the hand is thin and possesses loose connections with deeper planes, allowing free gliding [42].
• The palmar integument is subdivided into two separate zones by the oppositional crease of the thumb [32].
• The skin of the radial portion of the palm covers the thenar eminence and is the mobile portion [32].
• The skin of the ulnar and distal portion covers the hypothenar eminence where the skin has poor mobility [32].
• The web spaces are formed from the union of two nonsymmetrical cutaneous surfaces, with the palmar surface being flat and densely adherent to the commissural skeleton [32].
• The distal transverse ligament at the level of the thumb web is the deepest and most mobile commissural skeleton [32].

Prosthesis Design & Biomechanics

• The Touch® prosthesis consists of a mobile prosthetic head in a polyethylene insert that is freely moveable within a metal cup [22].
• The Touch® prosthesis comprises two concentric articulations: a smaller articulation between the head and polyethylene insert, and a larger articulation between the polyethylene insert and metal cup [22].
• The Touch® prosthesis uses metal-on-polyethylene bearings [22].
• The Touch® prosthesis is modular, composed of a titanium alloy stem (Ti–6Al–4 V), an M30 stainless steel intermediate implant, and an M30 stainless steel hemispheric cup [22].
• The Touch® prosthesis head has a 4-mm diameter covered by a pre-assembled high-density 7-mm diameter polyethylene insert [22].
• The Touch® prosthesis cup is available in two sizes: 9 and 10 mm in diameter [22].
• Implant fixation for the Touch® prosthesis is primary by a press-fit effect and secondary by means of a double-layer porous titanium and hydroxyapatite coating [22].
• The total in vitro range of motion of the Touch® prosthesis is 117 degrees [22].

Classification

• The Touch® prosthesis reproduces the dual mobility concept consisting of a mobile prosthetic head in a polyethylene insert that is freely moveable within a metal cup [22].
• The Touch® prosthesis utilizes metal-on-polyethylene bearings [22].
• The Touch® prosthesis stem is available in five sizes [22].
• The Touch® prosthesis intermediate implant has a 4-mm diameter head covered by a pre-assembled high-density 7-mm diameter polyethylene insert [22].
• The Touch® prosthesis polyethylene insert is available in three lengths and two angles [22].
• The Touch® prosthesis hemispheric cup is available in two sizes: 9 and 10 mm in diameter [22].
• The double-layer porous titanium and hydroxyapatite coating promotes and accelerates osteointegration [22].

Clinical Presentation

• A 53-year-old male professional cook presented with persistent clicking during thumb motion 12 months after Touch trapeziometacarpal arthroplasty [18].
• The patient reported no antecedent trauma or pain associated with the clicking noise [18].
• Grip and pinch strength were clinically evaluated and showed no difference compared with the opposite side [18].
• Standard radiographs taken 1 year after surgery did not demonstrate loosening of the implant [18].
• Computed tomography (CT) scan demonstrated a well-aligned implant without evidence of loosening [18].
• CT scan revealed a hint of a very small bone cyst but no loosening of the cup [18].
• Stress-view imaging using a fluoroscopic image intensifier revealed instability of the carpometacarpal I joint during the application of translatory stress forces on the thumb [18].
• Stress-view imaging showed a hint of possible decentralization of the head compared with the cup [18].
• The new diagnosis based on imaging was a fracture of the polyethylene (PE) liner [18].
• Revision surgery confirmed a fractured PE liner with an intact metallic head and stem [18].
• Exchanging only the liner restored stability [18].
• Follow-up radiographs 6 weeks after revision surgery confirmed the implant position remained satisfactory [18].
• Dynamic radiographic imaging with longitudinal traction is important for making a timely diagnosis of polyethylene liner fracture when standard radiographs are normal [20].

Investigations

• Standard radiographs (x-ray) are used to evaluate preoperative osteoarthritis and postoperative implant position, including stem subsidence, periprosthetic radiolucent lines, osteolysis, implant fracture, polyethylene wear, periprosthetic ossifications, and prosthetic dislocation or subluxation [27].
• Subsidence of the metacarpal component is evaluated by comparing the A/B ratio in percentage on strict lateral views immediately after surgery and at the last follow-up [27].
• A difference of more than 25% in the A/B ratio on strict lateral views is indicative of implant subsidence [27].
• Computed tomography (CT) scans can demonstrate a well-aligned implant without evidence of loosening even when clinical symptoms such as clicking are present [18].
• Stress-view imaging (dynamic x-ray) using a fluoroscopic image intensifier can reveal instability of the carpometacarpal I joint and possible decentralization of the head compared with the cup during the application of translatory stress forces [18].
• Preoperative assessment includes evaluation of the scaphotrapeziotrapezoid (STT) joint and confirmation of the absence of other thumb affections [27].
• Osteoarthritis is assessed preoperatively on standard anteroposterior and lateral radiographic views using the Eaton classification [27].

Treatment

Implant Design and Biomechanics

• The Touch® prosthesis head has a 4-mm diameter and is covered by a pre-assembled high-density 7-mm diameter polyethylene insert [22].

Surgical Technique

• A dorsolateral approach is used, protecting the superficial branch of the radial nerve and artery [25].
• The first dorsal compartment is released routinely, and the TMJ capsule is exposed between the extensor pollicis brevis and abductor pollicis longus tendons [25].
• A complete circumferential soft tissue release of the thumb metacarpal base is performed, including resection of the volar lip to facilitate delivery of the metacarpal base out of the wound [25].
• Osteophytes on the base of the metacarpal and the trapezium are resected to reduce the risk of impingement and dislocation [25].
• The distal articular surface of the trapezium is cut to be parallel with the STT joint [25].
• A K-wire is inserted under image guidance, centred in the trapezium, and the trapezium is reamed over the wire as recommended by the manufacturer [25].
• The MAÏA® dual mobility hemispherical cup is inserted with spikes facing the four corners of the trapezium to provide rotational stability [25].
• Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure [19].

Clinical Outcomes and Survival

• The Touch® prosthesis has a 96% implant survival rate at 2 years [4].
• The Touch® prosthesis provides promising patient-reported and clinical outcomes [4].
• Surgery with the Touch® prosthesis is recommended as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis [4].
• The Touch1 prosthesis allows for a fast return to work and leisure activity [7].
• Total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility, and clinical function with high patient satisfaction [10].
• The Elektra prosthesis observed fast pain relief, maintenance of mobility, and a gradual increase in grip strength [1].
• Due to poor outcomes after only 2 years, the Elektra implant cannot be recommended [8].
• The main complication for the Elektra prosthesis was loosening, which occurred frequently before 18 months in early versions [9].
• The loosening rate for the Elektra prosthesis never dropped below 17% at 4 years [9].
• The MAÏA trapeziometacarpal prosthesis represents a long-term solution for surgical treatment of thumb rhizarthrosis [6].
• MAÏA TMC joint prosthesis is a reliable long-term surgical procedure for TMC joint osteoarthritis, improving overall function beyond 10 years [23].
• MAêA TMC total joint arthroplasty provides very good results for pain relief, strength, mobility, and restoration of the thumb length [13].
• MAÏA TMC total joint arthroplasty provides correction of most thumb z-deformities [13].
• Correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty with unconstrained cups [11].
• The Moovis prosthesis is recommended for the treatment of advanced trapeziometacarpal osteoarthritis for people having an activity without too many manual constraints [5].
• Dual mobility arthroplasty for the thumb CMC joint osteoarthritis is a satisfactory solution with good functional results and absence of early and middle term dislocations [12].
• The Moovis prosthesis provides very good results at 1 year for rhizarthrosis [26].
• The Ivory arthroplasty provides improvement in overall function and pain reduction, and not every complication requires surgical revision [14].

Complications and Revision

• Polyethylene liner fracture in the Touch prosthesis can present as persistent clicking during thumb motion without antecedent trauma or pain [18].
• Standard radiographs may appear normal in cases of polyethylene liner fracture, while stress-view imaging reveals instability of the carpometacarpal I joint [18].
• Revision surgery for a fractured PE liner involves exchanging only the liner, which restores stability [18].
• Revision surgery for the Ivory® trapeziometacarpal prosthesis allows the stem to be retained due to compatibility with the Touch® prosthesis [16].
• Clinical and radiographic follow-up at 6 months after revision surgery for the Ivory® prosthesis was uneventful [16].

Complications

Implant Failure and Loosening

• Aseptic cup loosening is cited as the most common reason for implant failure in thumb carpometacarpal joint replacement arthroplasty [24].
• Aseptic cup loosening leads to revision rates of 42%–51% in thumb carpometacarpal joint replacement arthroplasty [24].
• The Elektra prosthesis had a loosening rate that never dropped below 17% at 4 years [9].
• Loosening of the Elektra prosthesis occurred frequently before 18 months in early versions [9].
• The Touch® trapeziometacarpal joint arthroplasty reported a 96% implant survival rate at 2 years [4].

Polyethylene Liner Fracture

• Standard radiographs and CT scans may show a well-aligned implant without evidence of loosening in cases of polyethylene liner fracture [18].
• Stress-view imaging using a fluoroscopic image intensifier can reveal instability of the carpometacarpal I joint and possible decentralization of the head compared with the cup in cases of polyethylene liner fracture [18].
• Revision surgery for polyethylene liner fracture in the Touch prosthesis can involve exchanging only the liner while retaining the intact metallic head and stem [18].

Intraoperative and Early Complications

• Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure in Moovis trapeziometacarpal joint arthroplasty [19].
• Osteophytes on the base of the metacarpal and the trapezium are resected to reduce the risk of impingement and dislocation during MAÏA® dual mobility CMC joint arthroplasty [25].

Instability and Dislocation

• The Moovis prosthesis showed an absence of early and middle term dislocations in a short series of 19 cases [12].
• The Moovis prosthesis showed an absence of prosthesis instability in a retrospective functional study of 28 prostheses [5].
• The Touch1 prosthesis appeared to be a safe and stable implant [7].

Revision and Salvage Considerations

• The Ivory® trapeziometacarpal prosthesis stem can be retained during revision surgery with the Touch® prosthesis [16].
• Not every complication of the Ivory arthroplasty requires surgical revision [14].

Recovery

• The Elektra prosthesis was associated with fast pain relief, maintenance of mobility, and a gradual increase in grip strength [1].
• The Touch prosthesis demonstrated a 96% implant survival rate at 2 years [4].
• The Touch prosthesis provided promising patient-reported and clinical outcomes [4].
• The authors of the 2-year Touch study recommend surgery with the Touch prosthesis as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis [4].
• The Moovis prosthesis was recommended for the treatment of advanced trapeziometacarpal osteoarthritis in people having an activity without too many manual constraints due to the absence of prosthesis instability [5].
• The Touch prosthesis provided good satisfaction and very good functional scores [7].
• The Touch prosthesis allowed for a fast return to work and leisure activity [7].
• The Elektra prosthesis had poor outcomes after only 2 years, leading the authors to not recommend this implant [8].
• Loosening was the main complication for the Elektra prosthesis, occurring frequently before 18 months in early versions [9].
• The rate of loosening for the Elektra prosthesis never dropped below 17% at 4 years [9].
• Correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty [11].
• Dual mobility arthroplasty for the thumb CMC joint provided good functional results and an absence of early and middle term dislocations [12].
• MAÏA TMC total joint arthroplasty provided very good results for pain relief, strength, mobility, and restoration of the thumb length [13].
• MAÏA TMC total joint arthroplasty provided correction of most thumb z-deformities [13].
• The Ivory arthroplasty resulted in an improvement in overall function and pain reduction [14].
• Not every complication following Ivory arthroplasty requires surgical revision [14].
• The Ivory arthroplasty is a reliable option for treating advanced trapeziometacarpal osteoarthritis, providing an important improvement in overall function and pain reduction [15].
• A 53-year-old male professional cook developed persistent clicking during thumb motion 12 months after Touch prosthesis implantation without antecedent trauma or pain [18].
• Grip and pinch strength were clinically evaluated and showed no difference compared with the opposite side in the patient with a fractured PE liner [18].
• Standard radiographs and CT scans in the patient with a fractured PE liner demonstrated a well-aligned implant without evidence of loosening [18].
• Exchanging only the liner restored stability in the patient with a fractured PE liner [18].
• Follow-up radiographs 6 weeks after liner exchange confirmed the implant position remained satisfactory [18].
• Dynamic radiographic imaging with longitudinal traction is important to make a timely diagnosis of polyethylene liner fracture when standard radiographs are normal [20].

Key Evidence

• [L4] Although the study observed fast pain relief, maintenance of mobility, and a gradual increase in grip strength, there was an increasing need for revision with a rate of 44% after 72 months. [1] (10.1177/1753193412443501)
• [L3] Trapeziometacarpal prosthesis shows promise for TMC arthrosis, enhancing function, thumb length, and patient recovery, warranting further research and x-ray guidance. [2] (10.1016/j.jhsg.2024.03.004)
• [L5] Limiting the magnitude of thumb loads after arthroplasty may contribute positively to the longevity of this procedure. [3] (10.1177/1753193416659230)
• [L4] The study reports a 96% implant survival rate at 2 years with promising patient-reported and clinical outcomes, leading the authors to recommend surgery with the TouchRV prosthesis as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis. [4] (10.1177/17531934231179581)
• [L4] The absence of prosthesis instability encourages us to recommend this technique for the treatment of advanced trapeziometacarpal osteoarthritis for people having an activity without too many manual constraints. [5] (10.1177/1558944718797341)
• [L4] The MAÏA trapeziometacarpal prosthesis represents a long-term solution for surgical treatment of thumb rhizarthrosis. [6] (10.1177/17531934221136442)
• [L4] The Touch1 prosthesis appeared to be a safe and stable implant, providing good satisfaction and very good functional scores and fast return to work and leisure activity. [7] (10.1016/j.hansur.2021.08.005)
• [L3] Because of these poor outcomes after only 2 years, the authors cannot recommend this implant. [8] (10.1177/1753193411414505)
• [L4] The main complication was loosening, which occurred frequently before 18 months in early versions, with a rate never dropping below 17% at 4 years. [9] (10.1016/j.main.2013.10.082)
• [L3] Total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function with high patient satisfaction. [10] (10.1186/s12891-024-07439-5)
• [L4] This study shows that correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty. [11] (10.1177/1753193417741237)
• [L4] Dual mobility arthroplasty for treatment of the thumb CMC joint osteoarthritis had proved, in this short series, to be a satisfactory solution for patients with good functional results and absence of early and middle term dislocations. [12] (10.1016/j.hansur.2017.10.128)
• [L4] MAÏA TMC total joint arthroplasty may be a reliable treatment option for TMC joint osteoarthritis, with very good results for pain relief, strength, mobility, and restoration of the thumb length, providing correction of most thumb z-deformities. [13] (10.1016/j.jhsa.2017.06.008)
• [L3] Nevertheless, there is an improvement in overall function and pain reduction and not every complication requires surgical revision. [14] (10.1016/j.hansur.2017.10.094)
• [L3] These long term results suggest that the Ivory arthroplasty is a reliable option for treating advanced trapeziometacarpal osteoarthritis, since it gives an important improvement in overall function and pain reduction. [15] (10.1016/j.hansur.2017.10.093)
• [L5] Clinical and radiographic follow-up at 6 months after surgery was uneventful. [16] (10.1016/j.hansur.2020.08.003)
• [L5] They agree that if the trial neck does not align with the centre of the trapezium, the cup position should be dictated by the neck to represent the new centre of rotation. [17] (10.1177/1753193418791435)
• [L5] [18] (10.1016/j.jhsg.2026.101045)
• [L2] Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure. [19] (10.1177/1753193420921307)
• [L4] This case highlights the importance of dynamic radiographic imaging with longitudinal traction to make a timely diagnosis of polyethylene liner fracture when standard radiographs are normal. [20] (10.1177/17531934241227918)
• [L5] Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis is not sufficiently reliable to be a routine solution for surgical revision of failed TMC arthroplasty or trapeziectomy; instead, it should be used with caution, primarily as a salvage solution if no safer alternative is available. [21] (10.1177/17531934231201914)
• [L4] [22] (10.1177/17531934211024500)
• [L4] MAÏA TMC joint prosthesis is a reliable long-term surgical procedure for TMC joint osteoarthritis, improving overall function beyond 10 years. [23] (10.1016/j.jhsa.2024.03.019)
• [L3] [24] (10.1177/1753193419873230)
• [L4] [25] (10.1177/17531934251410360)
• [L4] L’arthroplastie trapézométacarpienne par prothèse Moovis semble être une solution adaptée à la rhizarthrose avec de très bons résultats à 1 an. [26] (10.1016/j.main.2015.10.074)
• [L4] [27] (10.1177/1753193420901435)

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[17] Letter about a Published Paper: Can surgical guidelines minimize complications after Maïa® trapeziometacarpal joint arthroplasty with unconstrained cups?. Journal of Hand Surgery (European Volume). 2018. DOI: 10.1177/1753193418791435

[18] Polyethylene Liner Fracture in Touch Trapeziometacarpal Prosthesis: A Case Report. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101045

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