Five years ago I had a titanium thumb joint replacement. I've heard these haven't held up so well but mine seems okay. What's the latest?

Osteoarthritis of the trapeziometacarpal joint at the base of the thumb can be a painful disability. Surgical treatment is the final option when conservative care fails. Joint replacement has been popular.

In the past, silicone implants were used but problems with wear and tear led to the use of titanium implants instead. Pure titanium is smooth and fits into the bone but there have been problems. Studies show a high rate of implant failure in the first year.

Many patients have continued pain, swelling, and loss of function. In some cases, the implant sinks down into the bone. The net effect is loss of joint motion and function. In other cases, the implant shifts to the side with the same effect.

If you've had your implant with no problems for five years now, then you may have one of the more successful titanium implants. It may be a good idea to have periodic X-rays to look for the start of any changes that could lead to joint instability. Some hand surgeons are no longer using these implants instead using the soft tissue reconstruction available.

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