Surgical therapy of conservatively exhausted rhizarthrosis – total joint replacement or resection arthroplasty? A systematic review. - Report - MDSpire
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Surgical therapy of conservatively exhausted rhizarthrosis – total joint replacement or resection arthroplasty? A systematic review.
Comparative Analysis of Surgical Interventions for Advanced Rhizarthrosis
Overview
This systematic review compares total joint replacement with resection arthroplasty for advanced rhizarthrosis, highlighting that modern thumb CMC joint prostheses offer faster pain relief, earlier functional recovery, and superior short-term range of motion. However, meta-analyses suggest these early benefits may diminish over time.
Background
Rhizarthrosis, or osteoarthritis of the thumb carpometacarpal joint, is a common musculoskeletal disorder especially prevalent in women over 50. It leads to pain, functional impairment, and deformity due to joint degeneration. Surgical options have evolved from classical resection arthroplasty to advanced prosthetic implants with improved longevity and biomechanical stability. Recent generations of prostheses, such as dual-mobility models, demonstrate reduced complication rates and high patient satisfaction.
Data Highlights
Prosthesis Type
Follow-up (months)
Survival Rate (%)
Revision Rate (%)
Functional Improvement
First-generation (De la Caffinière)
60
66
Not specified
Limited longevity, loosening common
Second-generation (MAÏA)
134
88 (10 years)
8.7 (8/92)
QuickDASH improved from 61.3 to 19.6; ROM near contralateral side; grip strength +39%
Third-generation (TOUCH® dual-mobility)
78 (6.5 years)
Not specified
2 (1/61)
VAS pain decreased from 7.3 to 0.4; ROM and key pinch 102% contralateral
Key Findings
Modern thumb CMC joint prostheses provide faster postoperative pain relief compared to resection arthroplasty.
Prosthetic treatment results in earlier functional improvement and superior short-term range of motion.
Second-generation prostheses like MAÏA show 88% survival at 10 years with significant functional gains.
Third-generation dual-mobility prostheses demonstrate very low revision rates (~2%) and excellent mid-term outcomes.
Early advantages of prosthetic treatment over resection arthroplasty tend to diminish over longer-term follow-up.
Women are disproportionately affected by symptomatic rhizarthrosis, with prevalence increasing markedly with age.
Clinical Implications
Clinicians should consider modern thumb CMC joint prostheses for patients requiring surgical management of advanced rhizarthrosis to achieve faster pain relief and improved early function. The improved design and longevity of newer prostheses reduce complication and revision rates, making them increasingly favorable compared to traditional resection arthroplasty. However, long-term outcomes should be monitored as early benefits may lessen over time.
Conclusion
Advanced prosthetic implants for thumb CMC osteoarthritis offer superior short-term outcomes and patient satisfaction compared to resection arthroplasty, with evolving designs enhancing durability and safety. Surgical choice should balance early functional gains with long-term durability considerations.
Older patients with documented cognitive impairment also experienced greater postoperative functional decline following elective total knee arthroplasty
