Total joint arthroplasty versus trapeziectomy for trapeziometacarpal joint arthritis: 5-year follow-up of a randomized controlled trial.

Abstract

This study presents 5-year results of a randomized controlled trial comparing total joint arthroplasty (TJA) with the Maïa prosthesis and trapeziectomy for trapeziometacarpal joint osteoarthritis. Sixty-two women aged 40 and older scheduled for surgery were randomized. The primary outcome was daily hand function using the Michigan Hand Outcomes Questionnaire (MHOQ). Secondary outcomes included MHOQ subscales, range of motion, strength, satisfaction, complications and survival. Follow-up data were available for 28 TJA and 26 trapeziectomy patients. At 5-years, TJA did not show superior patient reported outcomes on the MHOQ compared with trapeziectomy. Grip and tip pinch strength differences were not statistically significant or clinically relevant. However, key pinch strength, satisfaction and willingness to undergo the same treatment again favoured TJA. There was no statistically significant difference in revision rates between the groups. Five-year survival was 73% for trapeziectomy and 93% for TJA.Level of evidence: I.