Poly-l/d-Lactide Implant (RegJoint) Versus Tendon Interposition for Trapeziometacarpal Inflammatory Arthritis: A 15-Year Follow-up of a Randomized Controlled Clinical Trial.

Abstract

Traditional surgical management of trapeziometacarpal (TMC) joint destruction in rheumatoid arthritis involves trapezial resection with tendon interposition. The poly-l-d-lactide RegJoint (Scaffdex, Tampere, Finland) implant offers an alternative with promising short-term results in rheumatoid patients. This study reports long-term outcomes from a randomized controlled trial comparing partial trapeziectomy with the RegJoint versus tendon interposition TMC arthroplasties in patients with inflammatory arthritis, including seropositive and juvenile rheumatoid arthritis, as well as a few cases of other inflammatory arthritis. A total of 13 patients with the RegJoint implant and 8 with tendon interposition completed a mean follow-up of 14.9 years. At final follow-up, no significant differences were found between the groups in pain, function (measured by visual analog scores), strength, or overall functional ability. However, both groups experienced a significant decrease in grip strength compared with preoperative and 2-year follow-up data, with the RegJoint group also reporting increased pain. Both RegJoint implant and tendon interposition provided comparable long-term outcomes for TMC arthroplasty in this small cohort of patients with inflammatory arthritis. Further studies are needed to confirm these findings.