Early Results of Thumb CMCJ Replacement - A Single Surgeon Series

Description

This presentation is delivered by Kem Ekpo, a registrar from the South East London rotation, and focuses on the early results of thumb carpometacarpal joint replacements conducted alongside Mr. Gidwani and Miss Andrea Bardos. The talk begins with a brief overview of trapeziectomy, which has traditionally been the preferred treatment for thumb arthritis, particularly in postmenopausal women. Dr Ekpo points out limitations of trapeziectomy for younger, more active patients, including slow recovery and insufficient improvement in grip strength, thus highlighting the need for an alternative solution such as carpometacarpal joint replacements.



He discusses the potential advantages of newer uncemented joint replacements, particularly those with a HA coating, which have shown promising results in emerging literature. After obtaining necessary clinical governance and visiting leading centres, this new implant was introduced at their trust. Ken details the study's design as a prospective cohort study, evaluating pain and function through patient-rated wrist and hand evaluation scores and key pinch strength measurements over a mean follow-up period of 40 months.



He outlines significant positive outcomes: the patient-rated wrist score decreased dramatically from an average of 59 pre-operatively to 15.6 post-operatively, while key pinch strength improved significantly, with some patients doubling their strength. Although there were some minor and major complications, most were manageable, and overall, the data suggests a low complication rate coupled with satisfactory improvements in both pain and function.



Dr Ekpo concludes by noting the importance of surgical technique in minimizing complications and explains that the implant is now in widespread use at their trust. Future goals include comparing this implant with dual mobility options to determine the best outcomes for patients.

DOI: 10.1302/3114-251219

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