Thumb CMC Prosthetic Replacement

November 23rd, 2007

Historically, thumb basal(CMC)joint prosthetic replacement has been unsuccessful--with high rates of loosening and late failure. This led to the current popularity of biologic solutions--most notably trapezium resection and ligament reconstruction techniques.

So why consider the newest prosthetic replacement? The reasons are as follows:

1.New data by Badia et al in the Journal of Hand Surgery (Jan 2006)shows successful outcome in select patients

2. This option--the Braun-Cutter device commercialized by Sbi Inc-- expedites recovery because the implant is cemented--just like a total knee and hip replacement

3. After 2 weeks in a splint, unrestricted use can begin, making this a superb option in the older patient who is looking for pain relief, good strength, but immediate recovery without the need for therapy

4.Despite popular belief, not all cases of trapezium resection and ligament reconstruction are completely successful, so an option like replacement that does not resect the entire trapezium may be worth considering if the arthritis is not too widespread--pantrapezial

Indeed, this option may be an option worth talking about during your appointment. I will review the pros and cons and assist you in making the right decision for you.

Related Photos:

Braun-Cutter Implant

Badia article published in J Hand Surgery 2006

Preoperative lateral xray shows Stage 2 arthritis

Intraoperative picture after cementation in this 72 yo patient

Postoperative xray

Related Videos:

Normal kinematics are restored with this replacement

Early outcome at 5 weeks

Outcome at 6 months in another patient