Randomized controlled trial shows comparable outcomes for RegJoint and tendon interposition in TMC joints, suggesting viability of both options.
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.
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Tiihonen et al. (2025) studied this question.
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