Daniel Schallmayer, Ahmed T. Sonbul, Gudrun H. Borchert, Christian Krasny
Total joint arthroplasty is a common surgical treatment option for trapeziometacarpal joint arthritis. The case report reflects the seldom complication of a fracture of the polyethylene liner in a double mobility trapeziometacarpal joint prosthesis (Touch). Unique about this case is that the affected patient had no symptoms despite a slight clicking during thumb abduction. X-rays and the clinical evaluation showed no abnormalities. A computed tomography scan and dynamic x-rays gave a hint about abnormal decentralization of the head. In a revision surgery, the fractured polyethylene liner was found as cause of the decentralization of the head and explained the slight clicking during thumb abduction. Changing the head of the implant restored the normal movement of the prosthesis without clicking. We suggest regular checks to detect implant failure as early as possible. This case shows that serious implant problems can be clinically unobtrusive, and early intervention can save the implant.