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Touch 拇指关节置换术

PDF Evidence Consent
Updated Oct 2026
一幅手绘插图，展示拇指与手指之间舒适地捏合的手部动作。
Touch 拇指关节置换术对拇指基底部的关节（即拇指基底关节炎中发生磨损的关节）进行表面置换，以恢复舒适的捏握功能。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

为何建议进行此手术

Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 医生会从适合您病情的最微创方案开始。患者通常由其全科医生（GP）转诊至我们的诊所；如果物理治疗师建议您就诊，您仍需获得全科医生的转诊，才有资格享受 Medicare 报销。在您的预约就诊时，我们会采集病史，检查您的手部，并在需要时安排影像学检查以确认诊断。

拇指基底部的磨损性（退行性）关节炎是引起疼痛和无力的常见原因。它会使捏物、抓握和转动钥匙变得困难。我们通常首先尝试非手术治疗，例如改变用手方式、手部治疗和支具固定。当这些措施未能给您带来足够改善时，才会考虑手术。

本手术即拇指关节置换术，是用人工植入物替换拇指基底部磨损的关节。该手术通常适用于关节炎仅限于该关节、且经非手术治疗疼痛仍未缓解的患者。我们可能向您建议这项手术，是因为它旨在缓解疼痛，恢复活动度、力量和稳定性，让您能够放心地使用拇指。大多数 Touch 植入物在 2 年时仍保留在位，报告的植入物存活率为 96%。该手术是否适合您，将由我们共同决定。

手术前

手术前几周，我们会通过拇指的影像学检查（例如X线、MRI或超声）来确认手术计划。这些影像能显示磨损的关节，并帮助我们规划置换手术。我们的团队会就术前准备给您明确的指示。您需要在手术前七小时停止进食和饮水。我们要求七小时而非六小时，以便如果手术室手术列表提前完成，可以将您的手术提前。有些药物需要暂停，我们会告诉您是哪些药物以及何时停用。请携带一份您目前所用药物的清单。请安排他人在术后驾车送您回家。请穿着宽松、舒适的衣物。如果您有其他健康状况，可能需要进行血液检查或由麻醉医生进行评估。

手术当天

手术当天，您需前往医院的手术入院单元。您将在该处办理入院手续并做术前准备。您将与麻醉医生见面，麻醉医生是在手术期间负责让您入睡并保持舒适的医生。本手术在全身麻醉下进行。手术过程中您将处于完全睡眠状态。部分患者可能还会接受区域神经阻滞以缓解术后疼痛；麻醉医生将根据您当天的具体情况决定是否实施。

随后，您将被带入手术室进行手术。手术结束后，您将在复苏区醒来，护士会在该处照看您，直至麻醉消退。一旦您的情况稳定，根据手术类型及恢复情况，您将被转入病房或直接回家。

手术内容

外科医生在拇指基底部上方做一个切口，以到达磨损的关节。受损的关节面被移除，并替换为人工部件：一个置入拇指骨内的小柄，以及一个安装在其旁边小骨中的臼杯。新部件设计为像健康关节一样相互活动，让您能够再次捏物和抓握。

目标是保持拇指的自然长度和对线，这有助于拇指的外观和功能尽可能接近正常。由于关节是被置换而非切除，带动拇指活动的肌肉和肌腱在捏物时无需那么费力。

置换部件安放到位后，外科医生会用缝线关闭切口并覆盖敷料。醒来时您的拇指会被包扎好，敷料需保留约10天。

之后，手部治疗师会指导您的康复。他们会教您在拇指愈合期间如何活动和使用拇指，并指导您何时可以提举物品以及可以提举多重。避免让新关节承受重负荷有助于延长其使用寿命。

术后

大多数患者在此手术后需在医院过夜一晚，但部分患者可于当日出院。您将在复苏区醒来，然后转入病房。护士会检查您的疼痛情况，并给您用药以保持舒适。您的拇指将用敷料包扎，并用夹板支撑。休息时请将手垫高放在枕头上；这有助于消肿。您可以起身在病房内走动，大多数事情您将用另一只手完成。请安排他人在您回家后的最初24小时内陪同您。敷料需保留约10天；除非我们告知您，否则请勿提前拆除。我们将在复诊时更换或拆除敷料。

恢复

术后最初几天，您的拇指会疼痛和肿胀。将手垫高放在枕头上有助于消肿。按医嘱服用普通止痛药，可让您在最难受的阶段保持舒适。

回家时您的拇指将佩戴夹板，敷料需保留约10天。术后的手部治疗由 Extend Rehabilitation 的 Ruby Doolan 负责。Ruby 是一名手部治疗师：她会教您一些轻柔的锻炼，在新关节愈合期间保持手指活动，并在拇指恢复过程中为您制作所需的夹板。她还会指导您何时可以提举物品以及可以提举多重，因为避免让新关节承受重负荷有助于延长其使用寿命。

日常生活中，起初大多数事情您将用另一只手完成。佩戴夹板期间您不能驾驶，因为夹板会妨碍您安全地握持方向盘。待夹板拆除且外科医生确认您可以驾驶后，方可开始驾驶；请参阅我们的上肢手术后驾驶页面。随着肿胀消退、活动度恢复，您将开始用拇指完成轻松的日常事务，然后逐步过渡到无痛地抓握和捏物。

每个人的恢复情况各不相同。您的恢复时间线可能有所不同，外科医生和手部治疗师会在每个阶段为您提供指导。

可能出现的问题

大多数患者恢复良好，但偶尔也可能出现问题。您的外科医生和医疗团队会密切监测您的状况，以便尽早发现任何问题。

新关节部件有时会松动。这通常表现为在一段时间缓解后，拇指基底部深部的酸痛再次出现或加重。如果您的拇指在术后数周或数月后再次疼痛，请致电诊所，以便我们安排影像学检查，查明原因。

关节也可能脱位，即新部件滑出原位。您会感到突然的“咔嗒”一下，随后出现疼痛，且拇指无法正常活动。如果发生这种情况，请立即致电诊所。

新关节周围的某块小骨可能在术中或术后发生骨折。这表现为远比预期严重的锐痛和肿胀。请致电诊所，以便我们进行检查。

拇指附近的神经可能受到刺激或挫伤。您可能会注意到拇指背侧出现刺痛、针扎感或麻木。神经阻滞后最初24小时内出现麻木和无力是预料之中的。神经阻滞消退后，如果麻木持续存在，或您无法活动拇指或手指，请致电诊所。

感染不常见，但后果严重。如果您出现发热、从伤口向外扩散的发红，或伤口有液体或脓液渗出，请当天致电诊所。如果您的拇指变得苍白、发凉、发白、发青或发黑，请前往急诊科，因为这可能是血液循环出了问题。

部分患者在术后会出现持续性的手部疼痛和敏感，有时伴有肿胀以及皮肤颜色或温度的改变。如果尽管服用了止痛药，疼痛仍持续加重，请当天致电诊所。

如果新关节效果不理想，有时需要再次手术。这可能意味着修复或更换植入物，或改做另一种手术：切除磨损的关节，并用您自身的组织填充该间隙作为衬垫。如果出现这种情况，我们会与您详细讨论各种选择。

本页上的并发症表列出了典型发生率，如果您想了解具体数据，可参考该表。

何时联系我们

大多数问题会在早期出现，我们希望尽早得知。如果您出现发热、从伤口向外扩散的发红、伤口有液体或脓液渗出，或者尽管服用了止痛药疼痛仍持续加重，请当天致电诊所。如果在神经阻滞消退后（术后约24小时），您仍有麻木，或无法活动拇指或手指，请致电我们。如果您出现小腿肿胀或疼痛、呼吸急促或胸痛，请前往急诊科，因为这些可能是血栓的征象。如果您的拇指变得苍白、发凉、发白、发青或发黑，也请前往急诊科。如果在非工作时间或周末无法联系到诊所，请前往最近的急诊科。

在哪里阅读更多关于该疾病的资料

本页介绍的是手术本身。该手术所治疗的疾病，包括证据显示手术在何时有帮助、在何时没有帮助，在拇指基底关节炎页面上有更详细的介绍。

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)

References

[1] Elektra prosthesis for trapeziometacarpal osteoarthritis: a follow-up of 39 consecutive cases. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412443501

[2] Comparative Analysis of Prosthetic (Touch) and Arthroplastic Surgeries for Trapeziometacarpal Arthrosis: Functional Outcomes and Patient Satisfaction With a 2-Year Follow-Up. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.03.004

[3] Total arthroplasty of basal thumb joint with Elektra prothesis: an in vitro analysis. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416659230

[4] Low complication rate and high implant survival at 2 years after Touch® trapeziometacarpal joint arthroplasty. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231179581

[5] Total Thumb Carpometacarpal Joint Arthroplasty: A Retrospective Functional Study of 28 MOOVIS Prostheses. HAND. 2018. DOI: 10.1177/1558944718797341

[6] Long-term survival analysis of 191 MAÏA® prostheses for trapeziometacarpal arthritis. Journal of Hand Surgery (European Volume). 2022. DOI: 10.1177/17531934221136442

[7] Touch® double mobility arthroplasty for trapeziometacarpal osteoarthritis: outcomes for 92 prostheses. Hand Surgery and Rehabilitation. 2021. DOI: 10.1016/j.hansur.2021.08.005

[8] Two-year outcomes of Elektra prosthesis for trapeziometacarpal osteoarthritis: a longitudinal cohort study. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193411414505

[9] Complications et évolution de la prothèse trapézo-métacarpienne Elektra dans une série homogène de 1100 implants. Chirurgie de la Main. 2013. DOI: 10.1016/j.main.2013.10.082

[10] Mid- and long-term clinical results of the Elektra and Moovis prosthesis for trapeziometacarpal joint replacement. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07439-5

[11] Can surgical guidelines minimize complications after Maïa® trapeziometacarpal joint arthroplasty with unconstrained cups?. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417741237

[12] Arthroplastie par prothèse trapézo-métacarpienne Moovis – une étude fonctionnelle rétrospective de 19 cas. Hand Surgery and Rehabilitation. 2017. DOI: 10.1016/j.hansur.2017.10.128

[13] MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 80 Patients With More than 6 Years of Follow-Up. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.008

[14] L’arthroplastie à rotule (Ivory[r]) comme traitement de l’arthrose trapezométacarpienne chez l’homme – le taux d’échec est-il plus élevé ?. Hand Surgery and Rehabilitation. 2017. DOI: 10.1016/j.hansur.2017.10.094

[15] Résultats de l’arthroplastie de type Ivory (r) dans le traitement de l’arthrose trapezométacarpienne avec un suivi d’au moins 10 ans – étude prospective cohorte d’un seul centre. Hand Surgery and Rehabilitation. 2017. DOI: 10.1016/j.hansur.2017.10.093

[16] Revision surgery for the Ivory® trapeziometacarpal prosthesis: compatibility with the Touch® prosthesis allows the stem to be retained. Hand Surgery and Rehabilitation. 2020. DOI: 10.1016/j.hansur.2020.08.003

[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

[19] Two-year results of the Moovis trapeziometacarpal joint arthroplasty with focus on early complications. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420921307

[20] Polyethylene liner fracture in dual mobility trapeziometacarpal total joint replacement: how to make a timely diagnosis?. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241227918

[21] Scaphometacarpal arthroplasty with a TOUCH® prosthesis: feasibility and biomechanical impact in a cadaver model. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231201914

[22] Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211024500

[23] MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 76 Patients With More Than 10 Years of Follow-Up. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.03.019

[24] Elektra prosthesis versus resection-suspension arthroplasty for thumb carpometacarpal osteoarthritis: a long-term cohort study. Journal of Hand Surgery (European Volume). 2019. DOI: 10.1177/1753193419873230

[25] Short-to-medium-term outcomes of MAÏA® dual mobility CMC joint arthroplasty. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934251410360

[26] Arthroplastie trapézométacarpienne à double mobilité Moovis – résultats préliminaires à 1 an de recul d’une série prospective. Chirurgie de la Main. 2015. DOI: 10.1016/j.main.2015.10.074

[27] The Moovis® implant for trapeziometacarpal osteoarthritis: results after 2 to 6 years. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420901435

[29] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 9Hand Surgery > Image DISORDERS OF THE MUSCULATURE OF THE HAND.

[30] Exam Of The Hand Wrist 2Ed. 1.1 SKELETON OF THE HAND > The osseous skeleton.

[31] Exam Of The Hand Wrist 2Ed. INTRODUCTION.

[32] Exam Of The Hand Wrist 2Ed. Functional cutaneous units.

[36] Exam Of The Hand Wrist 2Ed. The arches of the hand > The metacarpal arch.

[37] Exam Of The Hand Wrist 2Ed. Techniques of investigation of the arterial supply by J P Melki > Vascularization of the thumb > Palmar aspect.

[40] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 9Hand Surgery > FLEXOR TENDON INJURY.

[42] Exam Of The Hand Wrist 2Ed. The dorsal skin.

[43] Green S Operative Hand Surgery. PERTINENT ANATOMY.

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