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Handchir Mikrochir Plast Chir
DOI: 10.1055/a-2579-9277
Originalarbeit

Daumensattelgelenksarthrose: Aktuelle Therapiekonzepte im deutschsprachigen Raum

Thumb Carpometacarpal Joint Osteoarthritis: Current Concepts in German-Speaking Countries
Stefan Meuser 
1   Klinik für Hand- und Plastische Chirurgie, Helios Klinik Bonn/ Rhein-Sieg, Bonn, Germany
,
Elvira Bodmer
2   Handchirurgie, Zuger Kantonsspital AG, Baar, Switzerland
,
Nadine Briefer
3   Handchirurgie/ Obere Extremität, Schulthess Klinik, Zürich, Switzerland
,
Vanessa Reischenböck
3   Handchirurgie/ Obere Extremität, Schulthess Klinik, Zürich, Switzerland
,
Stephan Franz Schindele
3   Handchirurgie/ Obere Extremität, Schulthess Klinik, Zürich, Switzerland
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Zusammenfassung

Seit Einführung der 3. Generation der Daumensattelgelenksprothese mit dessen dual-mobility Prinzip haben sich die Therapiealgorithmen bezüglich der fortgeschrittenen, konservativ austherapierten Daumensattelgelenksarthrose im deutschsprachigen Raum teils erheblich geändert. Immer mehr Kliniken verwenden das Kunstgelenk als Therapie der ersten Wahl. Die Grenzen des endoprothetischen Gelenkersatzes werden neu definiert. Anhand des ersten Websymposiums der deutschsprachigen Arbeitsgemeinschaft für Handchirurgie (DAH) am 29.11.2023 wurden diese Fragen adressiert und mit einer breiten Zuhörerschaft diskutiert. Diese Arbeit soll einen Überblick über die stadienabhängigen Therapiekonzepte der Sattelgelenksarthrose und eine Zusammenfassung der Erkenntnisse aus dem Websymposium geben.

Abstract

The introduction of third-generation thumb carpometacarpal joint implants with a dual-mobility concept has significantly redefined the treatment algorithm for advanced thumb carpometacarpal joint osteoarthritis. Prosthetic arthroplasty is increasingly being adopted as the primary treatment choice in many clinical centres. The boundaries of prosthetic arthroplasty are being newly defined. These aspects were addressed and discussed with a broad audience during the first web symposium of the German-speaking Working Group for Hand Surgery (DAH) on 29 November 2023. This article provides an overview of the stage-dependent treatment concept of thumb carpometacarpal joint osteoarthritis and summarizes the insights of the web symposium.

Schlüsselwörter

Arthroplastik - Resektions-Arthroplastik, Handchirurgie - Daumensattelgelenk - Endoprothese - Rhizarthrose

Keywords

thumb carpometacarpal joint - osteoarthritis - prosthesis - arthroplasty - resection arthroplasty


Publication History

Received: 21 October 2024

Accepted: 31 March 2025

Article published online:
22 May 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Haara MM, Heliövaara M, Kröger H. et al. Osteoarthritis in the carpometacarpal joint of the thumb. Prevalence and associations with disability and mortality. J Bone Joint Surg Am 2004; 86: 1452-1457
    CrossrefPubMedSearch in Google Scholar
  • 2 Degeorge B, Chiche L, Coulet B. et al. Metacarpophalangeal joint instability in trapeziometacarpal osteoarthritis: A systematic review. Hand Surg Rehabil 2021; 40: S126-S134
    CrossrefPubMedSearch in Google Scholar
  • 3 Ledoux P. Metacarpophalangeal hyperextension in thumb basal joint osteoarthritis: Radiological study and implications for treatment. Hand Surg Rehabil 2023; 42: 56-60
    CrossrefPubMedSearch in Google Scholar
  • 4 Eaton RG, Glickel SZ, Littler JW. Tendon interposition arthroplasty for degenerative arthritis of the trapeziometacarpal joint of the thumb. J Hand Surg Am 1985; 10: 645-654
    CrossrefPubMedSearch in Google Scholar
  • 5 Ayache A, Spies CK, Unglaub F. et al. Die Resektionsarthroplastik bei Rhizarthrose. Orthopade 2022; 51: 65-78
    CrossrefPubMedSearch in Google Scholar
  • 6 Lögters T, Gehrmann S, Windolf J. Aktuelle Aspekte zur Therapie der Rhizarthrose. Unfallchirurg 2016; 119: 1000-1006
    CrossrefPubMedSearch in Google Scholar
  • 7 Falkner F, Tümkaya MA, Thomas B. et al. Konservative Therapieverfahren zur Behandlung der symptomatischen Daumensattelgelenksarthrose. Orthopade 2022; 51: 2-8
    CrossrefPubMedSearch in Google Scholar
  • 8 Becker SJE, Bot AGJ, Curley SE. et al. A prospective randomized comparison of neoprene vs thermoplast hand-based thumb spica splinting for trapeziometacarpal arthrosis. Osteoarthritis Cartilage 2013; 21: 668-675
    CrossrefPubMedSearch in Google Scholar
  • 9 Ahern M, Skyllas J, Wajon A. et al. The effectiveness of physical therapies for patients with base of thumb osteoarthritis: Systematic review and meta-analysis. Musculoskelet Sci Pract 2018; 35: 46-54
    CrossrefPubMedSearch in Google Scholar
  • 10 Cruz-Gambero L, Tuljak AL, Garcia Orza S. et al. Effectiveness of proprioception training in functional recovery of thumb osteoarthritis. Single, multicenter, non-blind randomized clinical trial. Reumatol Clin (Engl Ed) 2023; 19: 417-422
    CrossrefPubMedSearch in Google Scholar
  • 11 Herold C, Fleischer O, Allert S. Eigenfettinjektion in das Sattelgelenk zur Behandlung der Rhizarthrose – eine viel versprechende Therapieoption. Handchir Mikrochir Plast Chir 2014; 46: 108-112
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Haas EM, Volkmer E, Giunta RE. Pilotstudie über die Wirkung und den Nutzen von autologen Fettgewebstransplantaten bei Rhizarthrose verglichen mit einer Kortisoninjektion – 3 Monatsergebnisse. Handchir Mikrochir Plast Chir 2017; 49: 288-296
    Thieme ConnectPubMedSearch in Google Scholar
  • 13 Herold C, Lange J, Rennekampff HO. et al. Eigenfettinjektion bei Rhizarthrose: 5 Jahresergebnisse bei 42 Patienten. Z Orthop Unfall 2023; 161: 511-515
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Wong CW, Ho P. Arthroscopic Management of Thumb Carpometacarpal Joint Arthritis. Hand Clin 2017; 33: 795-812
    CrossrefPubMedSearch in Google Scholar
  • 15 Messina JC, Torretta F, Randelli PS. Autologous chondrocyte transplantation in the treatment of thumb CMC joint osteoarthritis. Hand Surg Rehabil 2021; 40: S21-S28
    CrossrefPubMedSearch in Google Scholar
  • 16 Spielman AF, Sankaranarayanan S, Lessard AS. Joint Preserving Treatments for Thumb CMC Arthritis Hand Clin. 2022 38. 169-181
    CrossrefPubMedSearch in Google Scholar
  • 17 Langer MF, Wieskötter B, Herrmann K. et al. Bandplastik bei Instabilität des Sattelgelenks. Oper Orthop Traumatol 2015; 27: 414-426
    CrossrefPubMedSearch in Google Scholar
  • 18 Bachoura A, Yakish EJ, Lubahn JD. Survival and Long-Term Outcomes of Thumb Metacarpal Extension Osteotomy for Symptomatic Carpometacarpal Laxity and Early Basal Joint Arthritis. J Hand Surg Am 2018; 43: 772.e1-772.e7
    CrossrefPubMedSearch in Google Scholar
  • 19 Baker RHJ, Al-Shukri J, Davis TRC. Evidence-Based Medicine: Thumb Basal Joint Arthritis. Plast Reconstr Surg 2017; 139: 256e-266e
    CrossrefPubMedSearch in Google Scholar
  • 20 Roux J-L. Double Oblique Osteotomy and Rotation of the trapeziometacarpal Joint (DOOR procedure). Hand Surg Rehabil 2021; 40: S53-S61
    CrossrefPubMedSearch in Google Scholar
  • 21 Zschöck-Holle A, Reik M, Wölfle O. et al. Behandlung der Rhizarthrose mittels Trapezium-Resektion und Swanson-Silikonprothese. Handchir Mikrochir Plast Chir 2015; 47: 7-16
    Thieme ConnectPubMedSearch in Google Scholar
  • 22 Lauwers TMAS, Brouwers K, Staal H. et al. Early outcomes of Pyrocardan® implants for trapeziometacarpal osteoarthritis. Hand Surg Rehabil 2016; 35: 407-412
    CrossrefPubMedSearch in Google Scholar
  • 23 Szalay G, Meyer C, Kraus R. et al. Die operative Versorgung der Rhizarthrose mittels Pyrocarbonspacer als Trapeziumersatz. Handchir Mikrochir Plast Chir 2009; 41: 300-305
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Menon J. Partial trapeziectomy and interpositional arthroplasty for trapeziometacarpal osteoarthritis of the thumb. J Hand Surg Eur Vol 1995; 20: 700-706
    CrossrefPubMedSearch in Google Scholar
  • 25 Chamay A, Piaget-Morerod F. Arthrodesis of the trapeziometacarpal joint. J Hand Surg Eur Vol 1994; 19: 489-497
    CrossrefPubMedSearch in Google Scholar
  • 26 Glehr M, Jeserschek R, Gruber G. et al. Klinische und radiologische Ergebnisse der Resektions-Suspensions-Interpositionsarthroplastik bei Rhizarthrose. Z Orthop Unfall 2010; 148: 326-331
    Thieme ConnectPubMedSearch in Google Scholar
  • 27 Schibli-Beer S, Mark G, Canova M. Ergebnisse nach alleiniger Trapezektomie und Kapselraffung bei der Behandlung der Rhizarthrose. Handchir Mikrochir Plast Chir 2008; 40: 169-174
    Thieme ConnectPubMedSearch in Google Scholar
  • 28 Hohendorff B, Staub L, Kaiser T. et al. Arbeitsfähigkeit nach Trapezium-Resektionsarthroplastik bei Rhizarthrose. Handchir Mikrochir Plast Chir 2008; 40: 175-181
    Thieme ConnectPubMedSearch in Google Scholar
  • 29 Krein R, Richter M, Brüser P. Does Epping resection arthroplasty lead to loss of hand strength? A prospective study. Handchir Mikrochir Plast Chir 2001; 33: 171-175
    Thieme ConnectPubMedSearch in Google Scholar
  • 30 Garcia-Elias M, Tandioy-Delgado FA. Modified Technique for Basilar Thumb Osteoarthritis. J Hand Surg Am 2014; 39: 362-367
    CrossrefPubMedSearch in Google Scholar
  • 31 Gervis WH. Osteo-arthritis of the Trapezio-metacarpal Joint treated by Excision of the Trapezium. Proc R Soc Med 1947; 40: 492
    CrossrefPubMedSearch in Google Scholar
  • 32 Obert L, Pluvy I, Zamour S. et al. Scaphotrapeziotrapezoid osteoarthritis: From the joint to the patient. Hand Surg Rehabil 2021; 40: 211-223
    CrossrefPubMedSearch in Google Scholar
  • 33 Tay SC, Moran SL, Shin AY. et al. The clinical implications of scaphotrapezium-trapezoidal arthritis with associated carpal instability. J Hand Surg Am 2007; 32: 47-54
    CrossrefPubMedSearch in Google Scholar
  • 34 Yuan BJ, Moran SL, Tay SC. et al. Trapeziectomy and carpal collapse. J Hand Surg Am 2009; 34: 219-227
    CrossrefPubMedSearch in Google Scholar
  • 35 Lussiez B, Falaise C, Ledoux P. Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years. J Hand Surg Eur Vol 2021; 46: 961-967
    CrossrefPubMedSearch in Google Scholar
  • 36 Martin-Ferrero M. Ten-year long-term results of total joint arthroplasties with ARPE® implant in the treatment of trapeziometacarpal osteoarthritis. J Hand Surg Eur Vol 2014; 39: 826-832
    CrossrefPubMedSearch in Google Scholar
  • 37 Toffoli A, Degeorge B, Cloquell Y. et al. MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 76 Patients With More Than 10 Years of Follow-Up. J Hand Surg Am 2024; 49: 846-856
    CrossrefPubMedSearch in Google Scholar
  • 38 Teissier J, Teissier P, Toffoli A. Trapeziometacarpal prostheses. Hand Surg Rehabil 2021; 40S: 106-116
    CrossrefPubMedSearch in Google Scholar
  • 39 Dreant N, Poumellec M-A. Total Thumb Carpometacarpal Joint Arthroplasty: A Retrospective Functional Study of 28 MOOVIS Prostheses. Hand (N Y) 2019; 14: 59-65
    CrossrefPubMedSearch in Google Scholar
  • 40 Andrzejewski A, Ledoux P. Maïa® trapeziometacarpal joint arthroplasty: Survival and clinical outcomes at 5 years’ follow-up. Hand Surg Rehabil 2019; 38: 169-173
    CrossrefPubMedSearch in Google Scholar
  • 41 Falkner F, Tümkaya AM, Thomas B. et al. Dual mobility prosthesis for trapeziometacarpal osteoarthritis: results from a prospective study of 55 prostheses. J Hand Surg Eur Vol 2023; 48: 566-574
    CrossrefPubMedSearch in Google Scholar
  • 42 Chammas P-E, Teissier J, Chiche L. et al. Revision of trapeziometacarpal arthroplasty. Hand Surg Rehabil 2024; 102066
    CrossrefPubMedSearch in Google Scholar
  • 43 Cerlier A, Guinard D, Gay AM. et al. Outcomes of secondary trapeziectomy after revision of trapeziometacarpal implants: a retrospective comparative matched study. J Hand Surg Eur Vol 2021; 46: 1096-1100
    CrossrefPubMedSearch in Google Scholar
  • 44 Armbruster EJ, Tan V. Carpometacarpal joint disease: addressing the metacarpophalangeal joint deformity. Hand Clin 2008; 24: 295-299 vii.
    CrossrefPubMedSearch in Google Scholar
  • 45 Degeorge B, Dagneaux L, Andrin J. et al. Do trapeziometacarpal prosthesis provide better metacarpophalangeal stability than trapeziectomy and ligamentoplasty?. Orthop Traumatol Surg Res 2018; 104: 1095-1100
    CrossrefPubMedSearch in Google Scholar
  • 46 Cebrian-Gomez R, Lizaur-Utrilla A, Sebastia-Forcada E. et al. Outcomes of cementless joint prosthesis versus tendon interposition for trapeziometacarpal osteoarthritis: a prospective study. J Hand Surg Eur Vol 2019; 44: 151-158
    CrossrefPubMedSearch in Google Scholar
  • 47 Herren DB, Marks M, Neumeister S. et al. Low complication rate and high implant survival at 2 years after Touch® trapeziometacarpal joint arthroplasty. J Hand Surg Eur Vol 2023; 48: 877-883
    CrossrefPubMedSearch in Google Scholar
  • 48 Bailey JR, Gorman PW, Mitchelson AJ. Metacarpophalangeal Joint Denervation in the Treatment of Dieterich Disease: A Case Report. Hand (N Y) 2020; 1558944720964964
    CrossrefPubMedSearch in Google Scholar
  • 49 Herren DB, Beaulieu J-Y, Calcagni M. et al. Current Trends in the Implantation of the Touch Prosthesis at the Thumb Carpometacarpal Joint: Results of the 1st German-Speaking User Meeting. Handchir Mikrochir Plast Chir 2024; 56: 201-211
    Thieme ConnectPubMedSearch in Google Scholar
  • 50 Athlani L, Motte D, Bergere M. et al. Scaphotrapeziotrapezoid joint loading during key pinch grip before and after trapeziometacarpal arthroplasty: a cadaver study. Hand Surg Rehabil 2023; 42: 45-50
    CrossrefPubMedSearch in Google Scholar
  • 51 Bütler S, Briefer N, Herren D. Nachbehandlung der Touch-Prothese und RSI-Arthroplastik - Schulthess Klinik. Im Internet https://www.youtube.com/watch?v=Koyl5elh_to Stand: 19.01.2024
    PubMed
  • 52 Dietrich E. Resektions-Suspensions-Interpositions- Arthroplastik des Daumensattelgelenks: Wieviel Schiene braucht es?. Zeitschrift für Handtherapie. 2017 01. 13-21
    PubMedSearch in Google Scholar
  • 53 Weiss S, Lastayo P, Mills A. et al. Splinting the degenerative basal joint: custom-made or prefabricated neoprene?. J Hand Ther 2004; 17: 401-406
    CrossrefPubMedSearch in Google Scholar
  • 54 Haase SC, Chung KC. An evidence-based approach to treating thumb carpometacarpal joint arthritis. Plast Reconstr Surg 2011; 127: 918-925
    CrossrefPubMedSearch in Google Scholar
  • 55 Wilcke M, Roginski M, Åström M. et al. A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis. BMC Musculoskelet Disord 2020; 21: 63
    CrossrefPubMedSearch in Google Scholar
  • 56 Gangopadhyay S, McKenna H, Burke FD. et al. Five- to 18-year follow-up for treatment of trapeziometacarpal osteoarthritis: a prospective comparison of excision, tendon interposition, and ligament reconstruction and tendon interposition. J Hand Surg Am 2012; 37: 411-417
    CrossrefPubMedSearch in Google Scholar
  • 57 Davis TRC, Brady O, Dias JJ. Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: A study of the benefit of ligament reconstruction or tendon interposition. J Hand Surg Am 2004; 29: 1069-1077
    CrossrefPubMedSearch in Google Scholar
  • 58 Downing ND, Davis TRC. Trapezial space height after trapeziectomy: Mechanism of formation and benefits. J Hand Surg Am 2001; 26: 862-868
    CrossrefPubMedSearch in Google Scholar
  • 59 Rezzadeh K, Donnelly M, Daar D. et al. Scaphometacarpal Space and Postoperative Outcomes: A Systematic Review. J Wrist Surg 2020; 9: 263-267
    Thieme ConnectPubMedSearch in Google Scholar
  • 60 Aliu O, Davis MM, DeMonner S. et al. The Influence of Evidence in the Surgical Treatment of Thumb Basilar Joint Arthritis. Plast Reconstr Surg 2013; 131: 816-828
    CrossrefPubMedSearch in Google Scholar
  • 61 Huang K, Hollevoet N, Giddins G. Thumb carpometacarpal joint total arthroplasty: a systematic review. J Hand Surg Eur Vol 2015; 40: 338-350
    CrossrefPubMedSearch in Google Scholar
  • 62 Remy S, Detrembleur C, Libouton X. et al. Trapeziometacarpal prosthesis: an updated systematic review. Hand Surg Rehabil 2020; 39: 492-501
    CrossrefPubMedSearch in Google Scholar
  • 63 Holme TJ, Karbowiak M, Clements J. et al. Thumb CMCJ prosthetic total joint replacement: a systematic review. EFORT Open Rev 2021; 6: 316-330
    CrossrefPubMedSearch in Google Scholar
  • 64 Raj S, Clay R, Ramji S. et al. Trapeziectomy versus joint replacement for first carpometacarpal (CMC 1) joint osteoarthritis: a systematic review and meta-analysis. Eur J Orthop Surg Traumatol 2022; 32: 1001-1021
    CrossrefPubMedSearch in Google Scholar
  • 65 Latelise B, Ben Brahim E, Prasil L. et al. Complications of prosthesis versus trapeziectomy in trapeziometacarpal joint arthritis: A systematic review. Hand Surg Rehabil 2024; 43: 101672
    CrossrefPubMedSearch in Google Scholar
  • 66 Dremstrup L, Thillemann JK, Kirkeby L. et al. Two-year results of the Moovis trapeziometacarpal joint arthroplasty with focus on early complications. J Hand Surg Eur Vol 2021; 46: 131-140
    CrossrefPubMedSearch in Google Scholar
  • 67 Tchurukdichian A, Gerenton B, Moris V. et al. Outcomes of Double-Mobility Prosthesis in Trapeziometacarpal Joint Arthritis With a Minimal 3 Years of Follow-Up: An Advantage for Implant Stability. Hand (N Y) 2021; 16: 368-374
    CrossrefPubMedSearch in Google Scholar
  • 68 Gonzalez-Espino P, Pottier M, Detrembleur C. et al. Touch® double mobility arthroplasty for trapeziometacarpal osteoarthritis: outcomes for 92 prostheses. Hand Surg Rehabil 2021; 40: 760-764
    CrossrefPubMedSearch in Google Scholar
  • 69 Froschauer SM, Holzbauer M, Mihalic JA. et al. TOUCH® Prosthesis for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Case Series. J Clin Med 2021; 10: 4090
    CrossrefPubMedSearch in Google Scholar
  • 70 Theyskens NC, Vandesande W. Dislocation in Single-Mobility Versus Dual-Mobility Trapezometacarpal Joint Prostheses. Hand (N Y) 2024; 19: 426-432
    CrossrefPubMedSearch in Google Scholar
  • 71 Van Melkebeke L, Caekebeke P, Duerinckx J. Early results of double mobility trapeziometacarpal total joint arthroplasty: prospective series of 82 Touch prosthesis. Minerva Orthop 2022; 73
    CrossrefPubMedSearch in Google Scholar