Revision of trapeziometacarpal arthroplasty: risk factors, procedures and outcomes

Figures & data

Table 1. Patient demographics

Patients and procedures
No. of patients	930
Sex (male/female)	121/809
Mean age	61 (34–92)
Primary procedures	1,142
Bilateral procedures	212
Revisions
No. of patients	50 (45 female)
Mean age	57 (43–80)
Revision procedures	65
Primary revision procedures	52
Cases with multiple revisions	9
Follow-up
Patients available	38
Mean follow-up, months	43 (8–132)

Table 2. Primary procedures and revisions

Primary procedures	Number of primary surgeries	Number of revisions (%)
Conventional arthroplasty
LRTI with APL tendon	679	32 (4.7%)
LRTI with APL tendon + bone tunnel	418	16 (3.8%)
Others		4^a
LRTI with FRC tendon	2	0
LRTI with EPB tendon	2	0
Interposition with palmaris longus tendon
without ligament reconstruction	5	0
Simple trapeziectomy	29	2
Partial trapeziectomy	7	2
Total number of procedures	1,142	52
Total number of patients	930	50

a revision rate not calculated due to small total number of operated patients.

Figure 1. Subsidence of the metacarpal against the scaphoid 3 years after LRTI with APL.

Figure 2. A remnant of the trapezium in the resection cavity after LRTI with APL.

Table 5. Risk factors for revision surgery

	Univariable conditional mixed model		Multivariable conditional mixed model
Risk factor	Odds ratio (95% CI)	p-value	Odds ratio (95% CI)	p-value
Surgery on both thumbs (negative risk)	49 (0.25–0.96)	0.04	0.42 (0.21–0.87)	0.02
Age, years
≤ 55	1.0		1.0
56–60	0.43 (0.21–0.88)	0.02	0.43 (0.21–0.87)	0.02
61–65	0.12 (0.04–0.42)	< 0.001	0.12 (0.04–0.41)	< 0.001
> 66	0.40 (0.19–0.87)	0.02	0.34 (0.15–0.76)	0.01
Sex	1.4 (0.55–3.8)	0.5	^a
Operated side	0.87 (0.50–1.5)	0.6	^a
Surgeon experience	1.04 (0.58–1.9)	0.9	^a
Surgical method
LRTI APL	1.0		^a
LRTI APL + bone tunnel	0.81 (0.43–1.5)	0.5
Others	2.0 (0.64–6.1)	0.2
Complications of primary surgery	0.83 (0.25–2.8)	0.8	^a
Immobilization time after surgery	1.6 (0.82–3.3)	0.2	^a
Simultaneous surgery on the metacarpophalangeal joint	0.70 (0.09–5.4)	0.7	^a
Other simultaneous surgeries	0.60 (0.21–1.7)	0.3	^a

a Odds ratio not calculated because no significance in univariable model.