Articular trapeziometacarpal and long fingers prosthesis

Thumb base joint arthroplasties are indicated in the arthritic deformities of the trapeziometacarpal joint, known as rhizarthrosis or CMC-1 arthritis. This pathology is almost degenerative, and rarely post-traumatic, and affects 20% of individuals over 55 years old, predominantly women. Surgical treatment is required in cases of failure of conservative orthosis-based treatment, including anti-inflammatory drugs, cortisone injections, and long-term immobilization. This surgical treatment has long consisted of trapeziectomy, or the removal of the trapezium. While this procedure yields good results in terms of pain relief, its recovery is long, and the loss of thumb strength and Z- deformities of the thumb are common. Over 50 years ago, a french surgeon, Dr. Jean-Yves de la Caffinière, developed the first trapeziometacarpal joint prosthesis. This initial model led to a significant evolution in design over the following decades, with the involvement of more surgeons from the French Orthopedic and Hand Surgery School , and the engagement of French industrial partners in the Research and Development (R&D) departments. These various ”Ball and Socket” models allowed the evolution of the initial concept and are the origin of modern prostheses, currently used in France, Europe, and worldwide.

Unfortunately, many models of these prostheses have disappeared from the catalog of French manufacturers, acquired by foreign companies, for purely economic reasons. Despite the economic constraints of the European MDR (Medical Devices Regulation), which still affect french companies in their R&D sector, thus not allowing the progress and evolution achieved in this field over the years.

We encounter the same issue of DMI (Medical Device Identifier) disappearance at the level of long finger joint prostheses, with the loss of known and reliable models from the catalogs of foreign companies that have acquired French manufacturers of these prostheses. Currently, only one model of finger joint prosthesis from a German manufacturer and silicone articular implants from a single French company remain.

In conclusion, although France has been at the forefront for the past fifty years in terms of significant progress in this field, it risks losing some models of thumb and long finger prostheses. However, this considerable decreasing choice and the threat of their disappearance endanger the health of our future patients.