Surgeons Stop Using Titanium Implants for Thumb Arthritis

Hand surgeons from Penn State College of Medicine no longer use titanium joint replacements for thumb osteoarthritis (OA). Based on the results of this study, they say the early failure rate of 20 percent is too high. The alternate surgery ligament reconstruction tendon interposition (LTRI) is more successful.

The authors say the patients who had successful titanium implants still had a weak pinch two years later. They comment that the titanium implant did not function as promised by the designers. Implant design, materials, and guidelines all contributed to a failed experience.

The biggest problem was movement of the implant. It either settled deeper into the bone or shifted to the side. Other patients reported continued discomfort or pain and swelling anytime they used the thumb. Failed cases ended up with an LTRI.

Titanium implants may still be used with low demand (inactive) patients who have good bone density. Even so, this group of hand surgeons has stopped using them for painful and disabling thumb OA. They use LTRI (soft tissue reconstruction) instead.

Reference: 

Sanjiv H. Naidu, MD, PhD, et al. Titanium Basal Joint Arthroplasty: A Finite Element Analysis and Clinical Study. In The Journal of Hand Surgery. May/June 2006. Vol. 31A. No. 5. Pp.760-765.

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