The poly-L/D-lactide joint scaffold (RegJoint™) has recently been associated with adverse tissue reactions and osteolysis after partial trapeziectomy for trapeziometacarpal osteoarthritis. Twenty-two of 23 patients previously operated on with this scaffold were re-examined at a mean follow-up of 3.3 years (range 36–53 months). Overall, the results showed an unacceptably high rate of adverse tissue reactions related to the degradation process of the implant, resulting in a revision procedure in three patients. At final follow-up, at which point the implant had completely degraded, there were no signs of ongoing adverse tissue reactions. There was a significant decrease in pain, increase in strength and subjective improvement in function at final follow-up compared with the pre-operative results in patients who had not undergone revision surgery. However, owing to the high incidence of adverse tissue reactions, the use of the implant has been discontinued in the treatment of trapeziometacarpal osteoarthritis.
CooneyWPChaoEY. Biomechanical analysis of static forces in the thumb during hand function. J Bone Joint Surg Am. 1977, 59: 27–36.
3.
CooneyWPLeddyTPLarsonDR. Revision of thumb trapeziometacarpal arthroplasty. J Hand Surg Am. 2006, 31: 219–27.
4.
DiaconuMMathoulinCFaccaSLiverneauxP. Arthroscopic interposition arthroplasty of the trapeziometacarpal joint. Chir Main. 2011, 30: 282–7.
5.
DiasJJBhowalBWildinCJThompsonJR. Assessing the outcome of disorders of the hand, is the patient evaluation measure reliable, valid, responsive and without bias. J Bone Joint Surg Br. 2001, 83: 235–40.
6.
EatonRGGlickelSZ. Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment. Hand Clin. 1987, 4: 455–71.
7.
HaaparantaAMUppstuPHannulaMElläVRoslingAKellomäkiM. Improved dimensional stability with bioactive glass fibre skeleton in poly (lactide-co-glycolide) porous scaffolds for tissue engineering. Mater Sci Eng C Mater Biol Appl. 2015, 56: 457–66.
8.
HonkanenPBKellomäkiMKonttinenYTMäkeläSLehtoMUK. A midterm follow-up study of bioreconstructive polylactide scaffold implants in metacarpophalangeal joint arthroplasty in rheumatoid arthritis patients. J Hand Surg Eur. 2009, 34: 179–85.
9.
HonkanenPBKellomäkiMLehtimäkiMYTörmäläPMäkeläSLehtoMU. Bioreconstructive joint scaffold implant arthroplasty in metacarpophalangeal joints: short term results of a new treatment concept in rheumathoid arthritis patients. Tissue Eng. 2003, 9: 957–65.
10.
HonkanenPBTiihonenRSkyttäETIkävalkoMLehtoMUKonttinenYT. Bioreconstructive poly-L/D-lactide implant compared with Swanson prosthesis in metacarpophalangeal joint arthroplasty in rheumatoid patients: a randomized clinical trial. J Hand Surg Eur. 2010, 35: 746–53.
11.
IkävalkoMSkyttäETBeltEA. One year results of use of poly-L/D-lactic acid joint scaffolds and bone packing in revision metacarpophalangeal arthroplasty. J Hand Surg Eur. 2007, 32: 427–33.
12.
KaarelaORaatikainenT. Abductor pollicis longus tendon interposition arthroplasty for carpometacarpal osteoarthritis of the thumb. J Hand Surg Am. 1999, 24: 469–75.
13.
KapandjiA. Clinical test of apposition and counter-apposition of the thumb. Ann Chir Main. 1986, 5: 67–73.
14.
MattilaSWarisE. Unfavourable short term outcomes of a poly-L/D-lactide scaffold for thumb trapeziometacarpal arthroplasty. J Hand Surg Eur. 2016, 41: 328–34.
15.
MegerleKGroulsSGermannGKloetersSHellmichS. Revision surgery after trapeziometacarpal arthroplasty. Arch Orthop Trauma Surg. 2011, 131: 205–10.
16.
MuermansSCoenenL. Interpositional arthroplasty with Gore-Tex, Marlex or tendon for osteoarthritis of the trapeziometacarpal joint. A retrospective comparative study. J Hand Surg Eur. 1998, 23: 64–8.
17.
PereiraAIchiharaSFaccaSHendriksSGouzouSLiverneauxP. Arthroscopic interposition in thumb carpometacarpal osteoarthritis: A series of 26 cases. Chir Main. 2015, 34: 307–11.
18.
RichardMLunichJCorrellG. The use of the Artelon CMC spacer for osteoarthritis of the basal joint of the thumb. J Hand Ther. 2014, 27: 122–6.
19.
SemereAForliACorcellaDMesquidaVLoretMGMoutetF. Foreign body reaction in osteoarthritis of the trapeziometacarpal joint treated by trapeziectomy and interposition of a L-polylactic acid “anchovy” (Arex615R). A series of eight cases. Chir Main. 2013, 32: 161–8.
20.
TiihonenRHonkanenPBBeltEaIkävalkoMSkyttäET (2012a) The mean seven years results of the use of poly-L/D-lactide acid (PLDLA) interposition implant and bone packing in revision metacarpophalangeal arthroplasty: a prospective cohort study. Scand J Surg101: 265–70.
21.
TiihonenRSkyttäEIkävalkoMKaleviKBeltE. Comparison of bioreplaceable implant arthroplasty with metatarsal head resection of the rheumathoid foot. Foot Ankle Int. 2010, 31: 505–10.
22.
TiihonenRPSkyttäETKaarelaKIkävalkoMBeltEA (2012b) Reconstruction of the trapeziometacarpal joint in inflammatory joint disease using interposition of autologous tendon or poly-L-D-lactide acid implants: a prospective clinical trial. J Plast Surg Hand Surg46: 113–9.
23.
TrumbleTERafijahGGilbertMAllanCHNorthEMcCallisterWV. Thumb trapeziometacarpal joint arthritis: partial trapeziectomy with ligament reconstruction and interposition costochondral graft. J Hand Surg Am. 2000, 25: 61–7.
24.
WarisEAshammakhiNLehtimäkiM, et al.. The use of biodegradable scaffold as an alternative to silicone implant arthroplasty for small joint reconstruction: an experimental study in minipigs. Biomaterials. 2008, 29: 683–91.
25.
WeilbyASondorfJ. Results following removal of silicone trapezium metacarpal implants. J Hand Surg Am. 1978, 3: 154–6.
