Osteoarthritis of the hand or trapeziometacarpal is a degenerative disorder of the articular cartilage. The evolution of the joint into a biconcave saddle joint has increased the importance of the stabilizing ligaments. When these are insufficient or are injured, they lead to the appearance of arthritic degeneration.
Generally, the origin of osteoarthritis responds to many biomechanical and biochemical factors that contribute to the production of the disease at the base of the thumb.
Who is usually affected?
It is a disease more frequent in women, with a much higher prevalence than in men. The cartilage and surrounding tissues are sensitive to estrogen-related compounds, which would explain why there is a gender predisposition to this disease.
On the other hand, there is also a different prevalence between Asian and Caucasian populations.
The average age of patients manifesting this degeneration is between 50 and 65 years of age, although at present younger patients are more frequently seen in our practice. This new trend could be related to the overuse of the thumb and new technologies.
Is there a treatment?
Currently, there are multiple surgical techniques to treat metacarpal arthrosis, such as ligamentous reconstruction, removal of the trapezium, metacarpal extension osteotomy, among others.
One of the most effective is the total metacarpal trapezium arthroplasty, which consists of the total replacement of this joint with an implant designed to achieve excellent function and the total disappearance of the patient’s pain.
What are the advantages over other methods?
This procedure has a number of advantages over other treatments. Mainly, it has a survival of the implant of more than 10 years in 90% of the cases and, on the other hand, there is a low rate of complications. Within this technique, what presents better results is the implantation of double mobility prosthesis, since it solves the problems of dislocation and loosening of the trapezium component in other previous implants.
Overall, the total trapezium metacarpal arthroplasty presents great advantages over other methods:
- Disappearance of pain
- Preservation of thumb length
- Joint stability
- Recovery of thumb mobility
- Very short recovery time
- Excellent aesthetic appearance
It is important to note that this technique is valid for patients with Rizarthrosis II-III of the Eaton classification, or Class II-III of Badia and patients with a Rizarthrosis of degenerative, inflammatory or traumatic origin.