Comparison between the MAIA Implant and Trapeziectomy for Trapeziometacarpal Osteoarthritis: Outcomes at 9 Years' Follow-Up.

The purpose of this retrospective study was to report and compare the outcomes of the MAIA prosthesis and trapeziectomy for trapeziometacarpal osteoarthritis. We included 92 consecutive patients (8 men, 84 women) with a mean age of 57 years (range 44-75 years) who underwent trapeziectomy (44 patients) or trapeziometacarpal joint replacement with a MAIA prosthesis (48 patients) for painful osteoarthritis. All patients were evaluated (pain, range of motion, strength, function, X-rays) by an independent examiner. The two groups of patients had comparable preoperative characteristics. At the mean follow-up of 9 years (range: 8-10), we found a significant reduction in pain levels for each group. In the final data review, there were no significant differences in terms of pain levels, grip strength, thumb active motion and the Quick Disabilities of the Arm, Shoulder and Hand score between the two groups. Pinch strength and the work performance score on the Michigan Hand Questionnaire were significantly better in the MAIA prosthesis group. The MAIA group had a shorter postoperative recovery time of 6 weeks and fewer patients required physiotherapy. Postoperatively, the thumb column length was significantly less in the trapeziectomy group. In this group, we found a significant decrease in the trapezial cavity height between the immediate postoperative evaluation and the final assessment, with three patients having painful scaphometacarpal impingement. Two patients required surgical revision for symptomatic meta-carpophalangeal joint hyperextension. In the MAIA group, we found no implant subsidence, loosening, dislocation or fracture. None of the implants were revised. From this study, we found that the both procedures can be used as a surgical treatment for trapeziometacarpal osteoarthritis. The MAIA prosthesis is a useful alternative to trapeziectomy and appears to be a reliable and effective implant in the medium- to long-term.