Dual mobility trapeziometacarpal prosthesis: a review of the current literature.

Abstract

Osteoarthritis of the first carpometacarpal joint is a common condition affecting up to 70% of the general population, with symptomatic disease occurring in 6% of cases, predominantly in postmenopausal women. Among the therapeutic options, total prosthetic replacement of the trapeziometacarpal joint is gaining prominence. The aim of this review is to provide a comprehensive update on dual mobility total arthroplasty of the trapeziometacarpal joint. PubMed, Google Scholar, and MEDLINE were searched for relevant publications that addressed the outcomes of dual mobility trapeziometacarpal prostheses. The Methodological Index for Non-Randomized Studies (MINORS) was used to assess the risk of bias. The effect model (EM) was calculated using the Cohen's d index. Ten studies with a total of 931 patients were included. Two prosthetic models were implanted (Moovis and Touch). Of the 931 implants, 25 failed (2.7%) and required surgical revision. The pooled random EM was 34.15 (95% CI, 23.53;44.77, I2 = 99%) for QuickDASH, -2.36 (95% CI, -4.24; -0.47, I2 = 99%) for Kapandji score, -7.49 (95% CI, -8.94; -6.04, I2 = 82%) for grip strenght, and -2.43 (95% CI, -2.92; -1.94, I2 = 91%) for key-pinch strenght. Dual mobility provides a good functional outcome in terms of range of motion and early recovery of pinch and grip strength, with a lower rate of dislocation compared to standard surgical procedures, and should be considered in patients with advanced trapeziometacarpal osteoarthritis with moderate functional demands.