JHS - 2026-03-04 - Journal Article; Review
Total Joint Arthroplasty for the Thumb Carpometacarpal Joint.
Tosti R, Duerinckx J
Topics
Key Takeaway
Total joint arthroplasty (TJA) for thumb CMC arthrosis has evolved significantly but no implant system has demonstrated superiority over trapeziectomy-based resection arthroplasty in controlled comparisons.
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Summary
This narrative review examines the design evolution, surgical technique, and clinical outcomes of total joint arthroplasty for thumb CMC arthrosis. It contextualizes TJA against trapeziectomy-based resection arthroplasty, which has been the dominant surgical approach since the 1940s. The review concludes that while TJA outcomes are generally favorable, no implant design has demonstrated clear clinical superiority over resection arthroplasty in terms of pain relief, strength, or function.
Key Limitation
As a narrative review without meta-analytic methodology, it cannot quantify implant-specific failure rates, complication profiles, or functional outcomes across studies, limiting actionable comparative conclusions.
Original Abstract
Thumb carpometacarpal joint arthrosis is the second most common form of degenerative joint disease in the hand but the most frequent form of arthrosis treated surgically. Traditional surgical management involving trapeziectomy dates to the 1940s, with several modifications having evolved to improve stability, strength, appearance, and convalescence. However, although most outcomes of resection arthroplasty are good, they fail to completely restore the joint to its previous vitality, and strong clinical evidence of superiority of any technique is lacking. As total joint arthroplasty remains one of the crowning achievements in orthopaedic surgery overall, attempts to recreate the thumb carpometacarpal joint have continued to develop. The purpose of this article is to discuss the progress, design, technical aspects, and outcomes of total joint arthroplasty in the thumb carpometacarpal joint.