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Touch thumb arthroplasty

Surgeon-side topic for touch thumb arthroplasty. Backed by 349 articles from the corpus, retrieved via combined MeSH + title-text matching.

18 citationsUpdated Aug 2026

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

Total joint arthroplasty for primary trapeziometacarpal joint arthritis yields low pain levels, excellent mobility, and clinical function with high patient satisfaction [6]. Limiting the magnitude of thumb loads after arthroplasty may contribute positively to the longevity of the procedure [1]. Trapeziometacarpal prosthesis shows promise for TMC arthrosis by enhancing function, thumb length, and patient recovery [8].

Elektra prosthesis: Provides fast pain relief, maintenance of mobility, and a gradual increase in grip strength [2]. However, there was an increasing need for revision with a rate of 44% after 72 months [2]. The authors cannot recommend the Elektra prosthesis due to poor outcomes after only 2 years [4].

TouchRV prosthesis: Demonstrates a 96% implant survival rate at 2 years [3]. It shows promising patient-reported and clinical outcomes [3]. Surgery with the TouchRV prosthesis is recommended as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis [3].

MOOVIS prosthesis: Shows an absence of prosthesis instability [5]. The MOOVIS technique is recommended for the treatment of advanced trapeziometacarpal osteoarthritis in people having an activity without too many manual constraints [5].

MAÏA prosthesis: Represents a long-term solution for surgical treatment of thumb rhizarthrosis [7]. It may be a reliable treatment option for TMC joint osteoarthritis [10]. The MAÏA prosthesis provides very good results for pain relief, strength, mobility, and restoration of the thumb length [10]. It provides correction of most thumb z-deformities [10].

Anatomy & Pathophysiology

Kinematics and Prosthetic Outcomes

Prosthetic Length Restoration: Trapeziometacarpal prosthesis enhances thumb length [8]. MAÏA TMC total joint arthroplasty provides restoration of thumb length [10].

Deformity Correction: MAÏA TMC total joint arthroplasty provides correction of most thumb z-deformities [10].

Stability Mechanisms: Applying the dual mobility principle to trapeziometacarpal arthroplasty may significantly improve the stability of these prostheses [13].

Revision and Salvage Considerations

Scaphometacarpal Arthroplasty Reliability: Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis is not sufficiently reliable to be a routine solution for surgical revision of failed TMC arthroplasty or trapeziectomy [14].

Salvage Indication: Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis should be used with caution, primarily as a salvage solution if no safer alternative is available [14].

Classification

Eaton Classification: Osteoarthritis severity is assessed preoperatively using standard anteroposterior and lateral radiographic views [16]. The scaphotrapeziotrapezoid (STT) joint is also assessed preoperatively to confirm the absence of other thumb affections [16].

Radiographic Assessment Criteria: Postoperative imaging evaluates stem subsidence, periprosthetic radiolucent lines, osteolysis, implant fracture, polyethylene wear, periprosthetic ossifications, dislocation/subluxation, and STT joint osteoarthritis [16]. Metacarpal component subsidence is quantified by comparing the A/B ratio on strict lateral views immediately post-surgery versus last follow-up; a difference exceeding 25% indicates subsidence [16]. Dynamic radiographic imaging with longitudinal traction is critical for timely diagnosis of polyethylene liner fracture when standard radiographs appear normal [11].

Prosthesis-Specific Outcomes: The Elektra prosthesis demonstrates fast pain relief, maintained mobility, and gradual grip strength increase, but exhibits poor outcomes at 2 years and a 44% revision rate at 72 months [2, 4]. The TouchRV prosthesis reports a 96% implant survival rate at 2 years with promising patient-reported and clinical outcomes [3]. The MOOVIS prosthesis shows no instability and is recommended for advanced osteoarthritis in patients with low manual constraints [5]. The MAÏA TMC total joint arthroplasty provides very good results for pain relief, strength, mobility, thumb length restoration, and correction of most thumb z-deformities [10].

Other Considerations: Trapeziectomy alone or with resection-suspension arthroplasty is widely established for thumb carpometacarpal (CMC) osteoarthritis, with no evidence of superiority over other techniques [15]. A major drawback of resection-suspension arthroplasty is proximal thumb migration, which compromises pinch strength and causes disability [15]. Total arthroplasty aims to maintain thumb length and achieve anatomical reconstruction [15]. However, results across various thumb CMC prostheses are inconsistent, particularly regarding complication and revision rates [15]. The primary drawback of replacement arthroplasty is aseptic cup loosening, the most common cause of failure, leading to revision rates of 42%–51% [15]. Despite these risks, numerous good to excellent outcomes have been published for thumb CMC prostheses [15]. Correct implant position yields reliable medium-term results [9]. Trapeziometacarpal prostheses show promise for enhancing function, thumb length, and recovery, but warrant further research and x-ray guidance [8].

Clinical Presentation

The clinical evaluation of trapeziometacarpal (TMC) osteoarthritis begins with preoperative assessment using the Eaton classification and evaluation of the scaphotrapeziotrapezoid (STT) joint [16]. Surgical options range from resection-suspension arthroplasty to various prosthetic replacements, each with distinct outcome profiles. Resection-suspension arthroplasty carries a major drawback of proximal thumb migration, which compromises pinch strength and causes disability [15]. Replacement arthroplasty faces significant risks, including aseptic cup loosening that leads to revision rates of 42%–51% [15].

Prosthetic selection requires careful consideration of long-term survival and functional outcomes. The Elektra prosthesis provides fast pain relief, maintains mobility, and gradually increases grip strength [2]. However, it demonstrates an increasing need for revision, with a rate of 44% after 72 months [2]. Poor outcomes observed after only 2 years lead to a recommendation against the use of the Elektra implant [4]. In contrast, the TouchRV prosthesis demonstrates a 96% implant survival rate at 2 years with promising patient-reported and clinical outcomes [3]. The MOOVIS prosthesis is recommended for advanced TMC osteoarthritis in patients with activities lacking significant manual constraints, supported by the absence of prosthesis instability [5]. The MAÏA TMC prosthesis represents a long-term solution, providing very good results for pain relief, strength, mobility, and restoration of thumb length [7], [10]. It is a reliable procedure that improves overall function beyond 10 years [17].

Technical precision is critical to avoid early failure. Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure with the Moovis prosthesis [12]. Postoperative radiographic assessment must evaluate stem subsidence, periprosthetic radiolucent lines, osteolysis, implant fracture, polyethylene wear, periprosthetic ossifications, prosthetic dislocation or subluxation, and STT joint osteoarthritis [16]. Implant subsidence is evaluated by comparing the A/B ratio in percentage on strict lateral views immediately after surgery and at the last follow-up [16]. A difference of more than 25% in the A/B ratio is indicative of implant subsidence [16]. Furthermore, dynamic radiographic imaging with longitudinal traction is important for the timely diagnosis of polyethylene liner fracture when standard radiographs are normal [11].

Investigations

Plain radiography: Standard anteroposterior and lateral views are used for preoperative assessment of trapeziometacarpal osteoarthritis using the Eaton classification [16]. Preoperative imaging must also assess the scaphotrapeziotrapezoid (STT) joint to confirm the absence of other thumb affections [16]. Postoperative radiographic evaluation for the Moovis implant monitors stem subsidence, periprosthetic radiolucent lines, signs of osteolysis, implant fracture, wear of the polyethylene component, periprosthetic ossifications, prosthetic dislocation or subluxation, and STT joint osteoarthritis [16]. Metacarpal component subsidence is evaluated by comparing the A/B ratio in percentage on strict lateral views immediately after surgery and at the last follow-up [16]. A difference of more than 25% in the A/B ratio is considered indicative of implant subsidence [16]. Dynamic radiographic imaging with longitudinal traction is important for making a timely diagnosis of polyethylene liner fracture when standard radiographs are normal [11].

Other Considerations: The Elektra prosthesis for trapeziometacarpal osteoarthritis showed fast pain relief, maintenance of mobility, and a gradual increase in grip strength [2]. However, there was an increasing need for revision of the Elektra prosthesis with a rate of 44% after 72 months [2]. Poor outcomes after only 2 years led to a recommendation against the use of the Elektra implant [4]. The TouchRV prosthesis demonstrated a 96% implant survival rate at 2 years [3]. The TouchRV prosthesis showed promising patient-reported and clinical outcomes at 2 years [3]. The authors recommend surgery with the TouchRV prosthesis as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis based on 2-year outcomes [3]. The MOOVIS prosthesis showed an absence of prosthesis instability [5]. The MOOVIS technique is recommended for the treatment of advanced trapeziometacarpal osteoarthritis in patients with activities without too many manual constraints [5]. Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure with the Moovis implant [12].

Treatment

Non-Operative

Total joint arthroplasty for primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility, and clinical function with high patient satisfaction [6]. Trapeziometacarpal prosthesis enhances function, thumb length, and patient recovery [8].

Operative

Indications: Surgery with the TouchRV prosthesis is recommended as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis based on 2-year outcomes [3].

Surgical Approach / Technique: The MAÏA surgery is performed under general anaesthesia with a pneumatic high arm tourniquet [18]. A single dose of intravenous pre-operative antibiotic prophylaxis is administered for MAÏA surgery [18]. A dorsolateral approach is used for MAÏA surgery, protecting the superficial branch of the radial nerve and artery [18]. The first dorsal compartment is released routinely during MAÏA surgery [18]. The TMJ capsule is exposed between the extensor pollicis brevis and abductor pollicis longus tendons during MAÏA surgery [18]. A complete circumferential soft tissue release of the thumb metacarpal base is performed during MAÏA surgery [18]. The volar lip is resected to facilitate the delivery of the base of the metacarpal out of the wound during MAÏA surgery [18]. Osteophytes on the base of the metacarpal and the trapezium are resected to reduce the risk of impingement and dislocation during MAÏA surgery [18]. The distal articular surface of the trapezium is cut to be parallel with the STT joint during MAÏA surgery [18]. A K-wire is inserted under image guidance, centred in the trapezium, and the trapezium is reamed over the wire during MAÏA surgery [18]. The MAÏA dual mobility hemispherical cup is inserted with the spikes facing the four corners of the trapezium to provide rotational stability during MAÏA surgery [18].

Implant Selection: The MAÏA TMC total joint arthroplasty provides very good results for pain relief, strength, mobility, and restoration of thumb length [10]. The MOOVIS prosthesis demonstrates an absence of prosthesis instability [5]. The Elektra prosthesis had poor outcomes after only 2 years, leading authors to not recommend this implant [4]. The revision rate for the Elektra prosthesis was 44% after 72 months [2].

Revision: Revision rates for replacement arthroplasty due to aseptic cup loosening range from 42% to 51% [15].

Complications

Aseptic loosening: Aseptic cup loosening is cited as the most common reason for implant failure in replacement arthroplasty [15].

Implant-specific outcomes: The Elektra prosthesis demonstrated a revision rate of 44% after 72 months [2] and yielded poor outcomes after only 2 years, leading authors to not recommend the implant [4]. In contrast, the TouchRV prosthesis had a 96% implant survival rate at 2 years [3].

Polyethylene wear: Polyethylene liner fracture in dual mobility trapeziometacarpal total joint replacement requires dynamic radiographic imaging with longitudinal traction for timely diagnosis when standard radiographs are normal [11].

Other Considerations: Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis is not sufficiently reliable to be a routine solution for surgical revision of failed TMC arthroplasty or trapeziectomy and should be used with caution, primarily as a salvage solution if no safer alternative is available [14].

Recovery

Light activity (weeks): Early postoperative management focuses on rapid symptom control and functional preservation. Implantation of the Elektra prosthesis provides fast pain relief [2], maintains mobility [2], and leads to a gradual increase in grip strength [2].

Full activity (months): Long-term functional outcomes vary significantly by implant type. At 2 years, the TouchRV prosthesis demonstrates a 96% implant survival rate [3], with promising patient-reported outcomes [3] and clinical outcomes [3]. In contrast, Elektra prosthesis outcomes are considered poor after only 2 years, leading authors to not recommend this implant [4]. For patients with activity without too many manual constraints, the MOOVIS prosthesis is recommended due to its absence of instability [5].

Complete recovery / outcome plateau (months): Total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels [6], excellent mobility [6], excellent clinical function [6], and high patient satisfaction [6]. The MAÏA prosthesis represents a long-term solution for surgical treatment of thumb rhizarthrosis [7]. With more than 6 years of follow-up, MAÏA TMC total joint arthroplasty provides very good results for pain relief [10], strength [10], mobility [10], restoration of the thumb length [10], and correction of most thumb z-deformities [10].

Rehabilitation protocol: Trapeziometacarpal prosthesis enhances function [8] and enhances patient recovery [8]. Technical precision is critical for specific implants; attentive reaming of the trapezium is a crucial step to avoid trapezial fracture and early cup failure with Moovis arthroplasty [12]. Careful cup impaction is a crucial step to avoid trapezial fracture and early cup failure with Moovis arthroplasty [12].

Key Evidence

  • [L5] Limiting the magnitude of thumb loads after arthroplasty may contribute positively to the longevity of this procedure. [1] (10.1177/1753193416659230)
  • [L4] Although the study observed fast pain relief, maintenance of mobility, and a gradual increase in grip strength, there was an increasing need for revision with a rate of 44% after 72 months. [2] (10.1177/1753193412443501)
  • [L4] The study reports a 96% implant survival rate at 2 years with promising patient-reported and clinical outcomes, leading the authors to recommend surgery with the TouchRV prosthesis as the standard treatment for patients with isolated trapeziometacarpal joint osteoarthritis. [3] (10.1177/17531934231179581)
  • [L3] Because of these poor outcomes after only 2 years, the authors cannot recommend this implant. [4] (10.1177/1753193411414505)
  • [L4] The absence of prosthesis instability encourages us to recommend this technique for the treatment of advanced trapeziometacarpal osteoarthritis for people having an activity without too many manual constraints. [5] (10.1177/1558944718797341)
  • [L3] Total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function with high patient satisfaction. [6] (10.1186/s12891-024-07439-5)
  • [L4] The MAÏA trapeziometacarpal prosthesis represents a long-term solution for surgical treatment of thumb rhizarthrosis. [7] (10.1177/17531934221136442)
  • [L3] Trapeziometacarpal prosthesis shows promise for TMC arthrosis, enhancing function, thumb length, and patient recovery, warranting further research and x-ray guidance. [8] (10.1016/j.jhsg.2024.03.004)
  • [L4] This study shows that correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty. [9] (10.1177/1753193417741237)
  • [L4] MAÏA TMC total joint arthroplasty may be a reliable treatment option for TMC joint osteoarthritis, with very good results for pain relief, strength, mobility, and restoration of the thumb length, providing correction of most thumb z-deformities. [10] (10.1016/j.jhsa.2017.06.008)
  • [L4] This case highlights the importance of dynamic radiographic imaging with longitudinal traction to make a timely diagnosis of polyethylene liner fracture when standard radiographs are normal. [11] (10.1177/17531934241227918)
  • [L2] Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure. [12] (10.1177/1753193420921307)
  • [L4] Applying the dual mobility principle to trapeziometacarpal arthroplasty may significantly improve the stability of these prostheses. [13] (10.1177/17531934211024500)
  • [L5] Scaphometacarpal arthroplasty using a trapeziometacarpal prosthesis is not sufficiently reliable to be a routine solution for surgical revision of failed TMC arthroplasty or trapeziectomy; instead, it should be used with caution, primarily as a salvage solution if no safer alternative is available. [14] (10.1177/17531934231201914)
  • [L3] [15] (10.1177/1753193419873230)
  • [L4] [16] (10.1177/1753193420901435)
  • [L4] MAÏA TMC joint prosthesis is a reliable long-term surgical procedure for TMC joint osteoarthritis, improving overall function beyond 10 years. [17] (10.1016/j.jhsa.2024.03.019)
  • [L4] [18] (10.1177/17531934251410360)

See Also

References

[1] Total arthroplasty of basal thumb joint with Elektra prothesis: an in vitro analysis. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416659230

[2] Elektra prosthesis for trapeziometacarpal osteoarthritis: a follow-up of 39 consecutive cases. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412443501

[3] Low complication rate and high implant survival at 2 years after Touch® trapeziometacarpal joint arthroplasty. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231179581

[4] Two-year outcomes of Elektra prosthesis for trapeziometacarpal osteoarthritis: a longitudinal cohort study. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193411414505

[5] Total Thumb Carpometacarpal Joint Arthroplasty: A Retrospective Functional Study of 28 MOOVIS Prostheses. HAND. 2018. DOI: 10.1177/1558944718797341

[6] Mid- and long-term clinical results of the Elektra and Moovis prosthesis for trapeziometacarpal joint replacement. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07439-5

[7] Long-term survival analysis of 191 MAÏA® prostheses for trapeziometacarpal arthritis. Journal of Hand Surgery (European Volume). 2022. DOI: 10.1177/17531934221136442

[8] Comparative Analysis of Prosthetic (Touch) and Arthroplastic Surgeries for Trapeziometacarpal Arthrosis: Functional Outcomes and Patient Satisfaction With a 2-Year Follow-Up. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.03.004

[9] Can surgical guidelines minimize complications after Maïa® trapeziometacarpal joint arthroplasty with unconstrained cups?. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417741237

[10] MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 80 Patients With More than 6 Years of Follow-Up. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.008

[11] Polyethylene liner fracture in dual mobility trapeziometacarpal total joint replacement: how to make a timely diagnosis?. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241227918

[12] Two-year results of the Moovis trapeziometacarpal joint arthroplasty with focus on early complications. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420921307

[13] Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211024500

[14] Scaphometacarpal arthroplasty with a TOUCH® prosthesis: feasibility and biomechanical impact in a cadaver model. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231201914

[15] Elektra prosthesis versus resection-suspension arthroplasty for thumb carpometacarpal osteoarthritis: a long-term cohort study. Journal of Hand Surgery (European Volume). 2019. DOI: 10.1177/1753193419873230

[16] The Moovis® implant for trapeziometacarpal osteoarthritis: results after 2 to 6 years. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420901435

[17] MAÏA Trapeziometacarpal Joint Arthroplasty: Clinical and Radiological Outcomes of 76 Patients With More Than 10 Years of Follow-Up. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.03.019

[18] Short-to-medium-term outcomes of MAÏA® dual mobility CMC joint arthroplasty. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934251410360

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c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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