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Objetive: The trapezio-metacarpal arthritis is a disabling disease that causes pain, decreased strength, loss of ability in the clamp and limited movement of the thumb. When medical treatment fails surgery can be performed in multiple ways. One of those may be prosthesis. From May 1999 to April 2004 were performed, consecutively, a total of 116 total prosthesis of the trapezio-metacarpal joint in 103 patients suffering from osteoarthritis, using uncemented and unconstrained ARPE® (Biomet Spain Orthopaedics SL, Valencia) prosthesis. Clinical, functional and radiological results at 10-year follow-up are presented. Survival analysis was performed using the Kaplan-Meier method. Methods: Of the 103 patients, 6 were excluded, remaining 97 patients with 109 prostheses that completed the study. Results: In a review of 10 years of evolution, 102 (93.6%) were functional prosthesis and 7 (6.4%) were considered failed prosthesis prostheses (3 removed by loosening of the cup, 3 were dislocated, and 1 with subluxation and painful). Survival estimate for functional implants over 10 years was 94.1% [95% CI (90.4%, 98.8%)]. Radiographically, 88 (86.3%) of the considered functional prostheses showed no evidence of alterations of the implant, and 14 (13.7%) showed radiographic changes that were compatible with the functionality of the implant. Complications are extensively presented in this study, with the possible solutions with revision surgeries. Conclusion: Total ARPE® prosthesis offers a safe and reliable alternative treatment in patients with trapezio-metacarpal osteoarthritis grade III and grade IV with some good bone stock, especially in the trapezius. Most complications occur due to indication defects or to defects of the surgical technique and can be solved with prosthetic replacement or trapeziectomy depending on the circumstances of the implant and of the patient.

Estudio a largo plazo (más de 10 años de evolución), de las complicaciones de las artroplastias trapecio-metacarpianas de tipo ARPE®