Article

When implanting the Maia(R) trapeziometacarpal prosthesis, surgeons will be faced
with a variety of complications they must be able to recognize and anticipate.
Their ability to deal with these complications and possibly even failures is
governed by their knowledge of the right steps to take.
The aim of this
retrospective study was to assess the incidence of complications reported during
implantation of the Maia(R) prosthesis, to describe their nature and potential
predisposing factors, and to study failures and their outcomes. Between January
2008 and December 2012, 156 Maia(R) prosthetic joints were implanted in 139
patients at one center by one surgeon. Clinical and radiological parameters were
analyzed before, during and after surgery. The implant characteristics were
documented and the surgical technique used was analyzed. The overall
postoperative complication rate was 35.9%. The most common complication (16%) was
tendinopathy. Prosthesis dislocation (4.5%) and trapezoid loosening (2.6%) were
the primary causes of failure. Eighteen patients required secondary surgical
revision (11.5%) and the implant was removed in 12 cases (failure rate of 7.7%).
Two factors were significantly correlated with the onset of complications,
independent of their nature and irrespective of whether secondary surgical
revision was required: a deformed thumb prior to surgery and the position of the
trapezial cup. Mediocre trapezium bone quality was a statistically significant
factor for secondary surgical revision. The survival rate of the Maia(R)
prosthesis was 90.8% at 62months. These factors influence the onset of
complications and must be taken into account in the pre-surgical workup in order
to identify the best candidates for successful Maia(R) joint replacement. For the
most part, the failure rate in our series was due to inappropriate surgical
technique rather than an inherent defect in the prosthesis. A meticulous, precise
surgical technique is therefore essential.
CI - Copyright (c) 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS