TOUCH® duo-mobile prosthesis in TMC osteoarthritis: two-year results and practical insights regarding key surgical steps and complication management.

INTRODUCTION

The Touch® dual-mobility prosthesis is a well-established treatment for advanced trapeziometacarpal (TMC) joint osteoarthritis, offering an alternative to resection arthroplasty. Short-term studies suggest dual-mobility designs reduce dislocation and loosening compared to single-mobility prostheses. This retrospective study presents clinical outcomes after a mean follow-up of 24 months, focusing on revision surgery and providing insights about key surgical steps and the management of adverse events.

MATERIALS AND

METHODS

A total of 78 patients (88 prostheses) with TMC osteoarthritis underwent surgery between August 2019 and December 2023, performed by a single surgeon in a monocentric setting. Preoperative assessments and follow-ups were conducted at 6 weeks, 6 months, 12 months, and annually. Outcome measures included radiographic analysis, range of motion, grip/pinch strength, pain (NRS 1-10), and functional scores (qDASH, briefMHQ). Complications and revisions were recorded.

RESULTS

At a mean follow-up of 24 months (range 6-61 months), significant improvements in hand function, pain, and mobility were observed. Preoperative thumb MCP hyperextension (> 15° in 23 thumbs) was corrected to 6° on average, and thumb length was restored. Four patients (4.5%) required implant revision: two due to secondary cup dislocation after misplacement, two due to impingement. Seven secondary surgeries addressed wound healing disorders (n = 2) and secondary De Quervain tenosynovitis (n = 5). Kaplan-Meier analysis showed a 96% prosthesis survival rate at two years.

CONCLUSIONS

The Touch® dual-mobility prosthesis demonstrates high effectiveness in improving pain, function, and thumb stability, with low revision rates. Restoration of thumb length and correction of hyperextension support its use as a reliable surgical option. These findings are consistent with existing literature suggesting superior long-term stability compared to single mobility implants. Identified surgical challenges highlight factors contributing to complications and emphasize intraoperative strategies to prevent revision.