Revision of failed Rubis II prostheses with a dual-mobility Touch implant.

Abstract

Objectives: Trapeziometacarpal osteoarthritis is the most prevalent upper limb arthropathy. Total joint arthroplasty has established itself as a trapezium-preserving alternative to trapeziectomy, but single-mobility implants carry a significant risk of dislocation. When revision is required, conversion to a dual-mobility implant is an appealing option, yet no published series has specifically evaluated the outcomes of this procedure. This study aimed to assess implant survival, functional outcomes and complications after revision trapeziometacarpal arthroplasty by conversion from the single-mobility Rubis II prosthesis to the dual-mobility Touch prosthesis.

Material and methods: A single-centre retrospective study was conducted at the Centre Hospitalier de Saint-Quentin, including all consecutive patients who underwent revision trapeziometacarpal arthroplasty by conversion to the Touch prosthesis between 2019 and 2025, with a minimum follow-up of six months. Functional outcomes were assessed using the QuickDASH and Patient-Rated Wrist Evaluation (PRWE) scores; pain was evaluated using a visual analogue scale (VAS). Complications and reoperations were recorded for all 30 cases. Implant survival without reoperation was estimated using Kaplan-Meier analysis.

Results: Thirty cases were included. Functional analysis was performed in 18 cases with available functional follow-up data (four excluded after secondary prosthesis removal, eight with missing data). Mean QuickDASH was 30.3 ± 26.2 and mean PRWE was 26.5 ± 23.5. VAS at rest was low (mean 0.9, median 0). Complications occurred in six cases (20.0%), comprising five mechanical complications (16.7%) and one persistent pain without reoperation (3.3%). Reoperation was required in five cases (16.7%), of which three occurred within four months. Kaplan-Meier survival without reoperation was 86.7% (95% CI: 68.3-94.8 %) at one year and 83.3% (95% CI: 64.5-92.7 %) at two years.

Conclusion: Revision trapeziometacarpal arthroplasty by conversion from a single-mobility Rubis II prosthesis to a dual-mobility Touch prosthesis is a feasible salvage option, achieving satisfactory functional outcomes, near-complete rest pain relief, and an implant survival without reoperation of 83.3% at two years.

Level of evidence: IV (retrospective observational study).