This prospective multicentre study reports outcomes of the Touch® dual mobility TMC prosthesis in 107 patients with thumb CMC arthritis at minimum 3-year follow-up. The central question is whether adapting the dual mobility principle from total hip arthroplasty can eliminate the persistent ~10% dislocation rate of conventional TMC implants.
Dislocation has been the Achilles heel of TMC arthroplasty since the first de la Caffinière prosthesis in 1973, occurring in up to 10% of cases and driving many surgeons back to trapeziectomy as the default.
This series shows that dual mobility engineering eliminates that failure mode entirely. When a patient with thumb CMC arthritis asks about prosthesis versus trapeziectomy, the dislocation concern no longer applies to this design.
The critical patient-selection rule this paper establishes: heavy manual labour predicts polyethylene wear failure at 3–4 years, so steer those patients toward trapeziectomy regardless of how good the stability data look.
When you see periprosthetic radiolucent lines on follow-up films, don't reflexively plan revision. Most are stress-shielding around the stem and remain stable. Track progression at each visit, and act only when cup lucent zones expand alongside symptoms.
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This prospective multicentre study reports outcomes of the Touch® dual mobility TMC prosthesis in 107 patients with thumb CMC arthritis at minimum 3-year follow-up. The central question is whether adapting the dual mobility principle from total hip arthroplasty can eliminate the persistent ~10% dislocation rate of conventional TMC implants.
Dislocation has been the Achilles heel of TMC arthroplasty since the first de la Caffinière prosthesis in 1973, occurring in up to 10% of cases and driving many surgeons back to trapeziectomy as the default.
This series shows that dual mobility engineering eliminates that failure mode entirely. When a patient with thumb CMC arthritis asks about prosthesis versus trapeziectomy, the dislocation concern no longer applies to this design.
The critical patient-selection rule this paper establishes: heavy manual labour predicts polyethylene wear failure at 3–4 years, so steer those patients toward trapeziectomy regardless of how good the stability data look.
When you see periprosthetic radiolucent lines on follow-up films, don't reflexively plan revision. Most are stress-shielding around the stem and remain stable. Track progression at each visit, and act only when cup lucent zones expand alongside symptoms.