# Joint Replacement Versus Trapeziectomy for Trapeziometacarpal Osteoarthritis: A Systematic Review

## TL;DR

This study compares two surgeries for hand arthritis: joint replacement and trapeziectomy, finding both effective but with different recovery and complication profiles.

## Contribution

A systematic review comparing joint replacement and trapeziectomy for TMC osteoarthritis, focusing on specific prostheses and long-term outcomes.

## Key findings

- Joint replacement offers faster recovery and better short-term function but has implant-specific complications.
- Trapeziectomy provides consistent long-term results with fewer implant-related issues but slower recovery.
- Both procedures effectively relieve pain and improve hand function for TMC osteoarthritis.

## Abstract

Trapeziometacarpal (TMC) osteoarthritis is a common and disabling condition affecting hand function and quality of life. When conservative management fails, surgical intervention is warranted. The two primary surgical options are trapeziectomy, often combined with ligament reconstruction and tendon interposition (LRTI), and total joint arthroplasty using prosthetic implants. The objective of our study is to compare the efficacy, functional outcomes, patient satisfaction, and complication profiles of trapeziectomy versus joint replacement for TMC osteoarthritis. This review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and specifically evaluates outcomes associated with the MAÏA™ (Groupe Lépine, France) and Touch® (KERIMEDICAL, Switzerland) prostheses compared to various trapeziectomy techniques. 11 studies, including retrospective and prospective cohort studies, a randomised controlled trial, and a same-patient comparison study, were analysed. Outcomes assessed included pain relief, grip and pinch strength, range of motion (ROM), patient-reported outcome measures (PROMs), recovery time, and complication rates. Both procedures effectively relieve pain and improve function. Joint replacement demonstrated superior short-term functional outcomes and faster recovery, particularly in strength restoration. However, it was associated with implant-specific complications. Trapeziectomy, while slower in recovery, showed consistent long-term efficacy and fewer implant-related issues. Both surgical options are viable. The choice should be individualised based on patient goals, anatomical considerations, and the balance between rapid functional recovery and implant-related risks.