Dubious space for Artelon joint resurfacing for basal thumb (trapeziometacarpal joint) osteoarthritis. A systematic review

AbstractIntroductionTrapeziometacarpal arthritis is a common and disabling condition. There is no evidence in the literature of superiority of one surgical procedure over others. Several prosthetic implants have been introduced to preserve joint mobility.Sourced of dataWe searched the on Medline (PubMed), Web of Science and Scopus databases using the combined keywords ‘artelon’, ‘thumb’, ‘carpometacarpal’, ‘trapeziometacarpal’ and ‘rhizoarthrosis’; 11 studies were identified.Areas of agreementThe use of Artelon implant is not recommended because of its high revision rate and worse outcomes compared to conventional techniques.Areas of controversyInert materials subjected to compressive and shearing forces could produce debris and subsequent inflammatory response. There is debate in the published scientific literature regarding the role of preoperative antibiotic profilaxis and post-surgery inflammatory response.Growing pointsStandard techniques such as trapeziectomy alone or combined with interposition or suspensionplasty offer effective treatment for thumb basal joint arthritis.Areas timely for developing researchSeveral prosthetic implants show promising results in terms of pain relief and functional request, but there is a need of long-term randomized controlled trials to demonstrate their equivalence, and eventually superiority, compared to standard techniques.
Source: British Medical Bulletin - Category: General Medicine Source Type: research