Revision Thumb Carpometacarpal Arthroplasty.

Hand Clin · May 2022 · Review

Johnson SP, Chung KC

Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School

Hand & Upper Extremity

SUMMARY — THE REDUCTIONReviews causes and outcomes of failed thumb CMC arthroplasty, noting revision surgery improves pain and instability but carries higher complication rates and lower satisfaction than primary surgery.
Abstract, as published

Revision thumb carpometacarpal (CMC) arthroplasty alleviates persistent pain and instability after nonimplant or implant CMC arthroplasty. Metacarpal subsidence onto the scaphoid causing impingement, missed diagnosis such as scaphotrapezoid arthritis, and metacarpophalangeal hyperextension are common causes of failed CMC arthroplasty. Literature shows that revision CMC arthroplasty has satisfactory outcomes. Currently, the mantra of revision is to restore the metacarpal height and treat concomitant pathology, but no single operation is a universal solution. Revision CMC arthroplasty has a relatively high complication rate, lower patient satisfaction than primary CMC arthroplasty, and may result in the need for further operative intervention.

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