Clinical management of trapeziometacarpal joint infections: a European Delphi consensus and literature review
Introduction: Periprosthetic joint infections (PJIs) of the trapeziometacarpal joint of the thumb are rare but challenging complications of arthroplasty. Currently, no hand-specific guidelines exist. This study aimed to develop consensus-based recommendations for their diagnosis and management. - Me...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
December 1, 2025
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| In: |
The journal of hand surgery. European volume
Year: 2025, Pages: 17531934251385450 |
| ISSN: | 2043-6289 |
| DOI: | 10.1177/17531934251385450 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1177/17531934251385450 Verlag, lizenzpflichtig, Volltext: https://journals.sagepub.com/doi/10.1177/17531934251385450 
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| Author Notes: | Simeon C Daeschler, Benjamin Panzram, Joris Duerinckx, Marion Muehldorfer-Fodor, Tobias Lutz, Stephane Barbary, Burkhard Lehner, Sabrina Klein, Thomas Krohn, Arne Hendrik Boecker, and Victoria F Struckmann |
| Summary: | Introduction: Periprosthetic joint infections (PJIs) of the trapeziometacarpal joint of the thumb are rare but challenging complications of arthroplasty. Currently, no hand-specific guidelines exist. This study aimed to develop consensus-based recommendations for their diagnosis and management. - Methods: A three-round Delphi process was conducted with seven European hand surgeons experienced in trapeziometacarpal joint arthroplasty. Consensus was defined as ⩾80% agreement (strong) and 65-79% (moderate). A scoping literature review of hand and large-joint PJIs was performed to support expert statements. - Results: All suspected infections were recommended to be managed surgically, with strong support for debridement and prosthesis neck exchange in acute infections. Trapeziectomy was endorsed as a salvage strategy in acute and chronic cases. Six weeks of antibiotic therapy, initiated intravenously and followed by oral administration, was strongly recommended. Amoxicillin/clavulanate and clindamycin were preferred empirical agents. The use of rifampicin was conditionally supported in confirmed Staphylococcus aureus infections. A 12-week interval between intraarticular corticosteroid injection and prosthesis implantation was recommended. - Discussion: This Delphi process, supported by literature review, provides the first structured guidance for the management of PJIs of the trapeziometacarpal joint of the thumb. Recommendations align with principles from large-joint infection management but are tailored to the anatomical and clinical context of the hand. These statements establish a practical framework for clinical decision-making and highlight priorities for future research. - Level of Evidence: IV |
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| Item Description: | Gesehen am 26.02.2026 |
| Physical Description: | Online Resource |
| ISSN: | 2043-6289 |
| DOI: | 10.1177/17531934251385450 |