Result
In all, 137 patients (151 thumbs) were reviewed at a mean of 60,5 months (range 55-66), after the procedure. Most of the patients were women: 102 women and 35 men. The mean age was 61,6 years (range 46-78 years) at the time of the surgery. The dominant hand was affected in 79% of patients and 38% had already undergone trapeziectomy with LRTI (Zancolli technique) for basal joint arthritis in their contralateral hand.83 right thumbs and 54 left thumbs were treated; 91 of the treated thumbs were dominant (Table 2).
Table 2.  Description of population
137 Patients  151 Thumbs
102 Female  35 Male
83 Righ hand  54 Left Hand 129 number nine cups were implanted in the trapezium and 8 number ten,97 number nine and 40 number ten stems were implanted in the first metacarpal. An angulated neck was used in 122 case and 15 straight neck was used.
The Eaton-Littre grade(4) was: Grade II in 2 cases, grade III in 101 cases and grade IV in 34 case.
The subjective outcome was satisfactory in 126 cases (92%), 14 (10%) patients would undergo the same procedure in the other hand. The DASH questionaries was 19.55 (range 5.6-33,5) on average, and EVA was 1 on average. The mean key pinch strength was 5.8 Kg at 5 years follow-up.
There were a high rate 29 cases (21%) of De Quervain`s tenosynovitis, these complications occur around the 3rd month and it was recovery with conservative treatment.
77% demonstrated no evidence of loosening or subsidence. 13% demonstrated changes. Cup loosening in five case (3,6%). The other radiologically changes were minor abnormalities without clinical impact like slight mal positioning of components, partial areas of radiolucency around cup or and heterotopic bone around de joint.
The prosthesis was removed in nine cases (7%) six at five years and three at four years. A trapezectomy and ligament reconstruction and LTRI (Welby technics) was performed in all case of prosthesis loosening with clinical impact.
There were four intraoperative trapezial fracture (3%) that occurred on impaction of the cup, immobilization for 6 weeks was enough for three patients and in one case trapezctomy and LRTI was necessary since impaction of the cup was not possible.
Five (3,6%) traumatic dislocation occurred along five years, in three cases close reduction and immobilization was undertaken for 3 weeks and the normal function was recovered, and in two case the cup was loosening, and new surgery was performed (Welby Technic).
The survival rate for ARPE prosthesis was 92,7% at 60,5 months.