Archives of Orthopaedic and Trauma Surgery - 2026-03-12 - Journal Article; Review
Surgical therapy of conservatively exhausted rhizarthrosis - total joint replacement or resection arthroplasty? A systematic review.
Boever J, Unglaub F, Spies CK, Cavalcanti Kußmaul A, Wulf J, Böcker W, Ayache A
Topics
Key Takeaway
Latest-generation thumb CMC prostheses show low loosening and dislocation rates with faster rehabilitation compared to resection arthroplasty, though both provide effective pain relief and high patient satisfaction.
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Summary
This systematic review compared clinical outcomes, functional results, and complication profiles of resection arthroplasty (trapeziectomy ± ligament reconstruction) versus latest-generation thumb CMC total joint replacement for advanced rhizarthrosis. Both procedures achieved effective pain relief and high patient satisfaction; however, newer CMC prostheses demonstrated lower loosening and dislocation rates than earlier implant generations, faster rehabilitation, and preservation of thumb length. The authors conclude that procedure selection should be individualized based on age, activity level, and functional demands.
Key Limitation
The number of included studies and total patient population are not disclosed in the available text, making it impossible to evaluate the robustness of the pooled conclusions or the quality of evidence synthesis.
Original Abstract
UNLABELLED
Rhizarthrosis is a common degenerative disorder of the carpometacarpal joint of the thumb, significantly impairing hand function due to pain and loss of mobility. While conservative and joint-preserving measures are the first-line treatment in early stages, advanced disease often requires surgical intervention. The aim of this study was to evaluate and compare the clinical outcomes, functional results, and complication profiles of resection arthroplasty versus latest generations of thumb carpometacarpal joint prostheses. Resection arthroplasty has proven to be a reliable therapy, providing effective pain relief and high patient satisfaction. Latest generations of thumb carpometacarpal joint prostheses demonstrate low rates of loosening and dislocation, along with advantages such as faster rehabilitation, preservation of thumb length, and good functional outcomes. The choice of procedure should be individualized, considering age, activity level, and functional requirements.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s00402-025-06180-5.