Total trapeziometacarpal arthroplasty. Report on seventeen cases of de generative arthritis of the trapeziometacarpal joint.

The authors have studied the results of 17 total trapeziometacarpal arthroplasties, performed in 15 patents between 1973 and 1983. The indications were essentially arthritis of the trapeziometacarpal joint either isolated or associated with peritrapezial lesions. The mean follow-up period was 3 years, the extremes ranged from 1 to 10 years. Results were judged as good in 13 cases, average in one case with 3 failures. Good results allow to recuperate complete mobility with adequate strength and stability.. The key point of this study was that first, cemented total arthroplasty does not represent a surgical escalade, a repeat operation is always possible in case of failure, and second, the concept of peritrapezial arthritis, and especially Crosby's stage 1 or stage 2 scaphotrapezial arthritis, is not a contraindication for total trapeziometacarpal arthroplasty. The best indications seems to be intense Dell's stage 3 or stage 4 trapeziometacarpal arthritis either isolated or associated with moderated peritrapezial arthritis. Two elements must be particularly studied before thinking about total trapeziometacarpal arthroplasty: the size, the consistancy and the configuration of trapezium; the degree of eventually associated scaphotrapezial arthritis.