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Journal of Hand Surgery (British and European Volume)
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Articles

Use of the De La Caffinière Prosthesis in Rheumatoid Trapeziometacarpal Destruction

E. T. SKYTTÄ
E. A. BELT
H. J. KAUTIAINEN
J. T. LEHTINEN
M. IKÄVALKO
H. M. MÄENPÄÄ

From the Rheumatism Foundation Hospital, Heinola, Finland, Kanta-Häme Central Hospital, Hämeenlinna and Tampere University Hospital, Tampere, Finland

Correspondence: Correspondence and requests for off-prints: Dr Eero A. Belt, MD, PhD, Rheumatism Foundation Hospital, FIN-18120 Heinola, Finland. Tel.: +358 3 8491821; fax: +358 3 8491512 E-mail: eero.belt{at}reuma.fi

This study evaluated the outcome of the de la Caffinière prosthesis in patients with an inflammatory arthropathy affecting the trapeziometacarpal joint. The procedure was performed in 57 thumbs for rheumatoid arthritis (41 cases), juvenile chronic arthritis (ten cases), psoriatic arthritis (four cases) and other inflammatory joint diseases (two cases). Survival analysis with a revision procedure or radiographic implant failure as end points was performed. Five loosened cups and two permanently dislocated prostheses underwent revision surgery. These were managed with a bone graft and tendon interposition technique. Radiographic follow-up yielded four additional implant failures (two loosened cups, one loosened metacarpal stem and one permanent dislocation). The implant survival rate based on revision operation was 87% (95% CI 73–94) at 10 years, and the total radiographic and implant failure rate based on radiographic findings was 15% (95% CI 7–29) at 10 years.

Key Words: trapeziometacarpal joint • rheumatoid arthritis • surgical treatment • trapeziometacarpal prosthesis

Journal of Hand Surgery (British and European Volume), Vol. 30, No. 4, 395-400 (2005)
DOI: 10.1016/J.JHSB.2005.03.012
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