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The present study compares 34 patients with thumb carpometacarpal osteoarthritis (37 thumbs) treated with the Elektra® prosthesis, with 18 patients (18 thumbs) treated with resection-suspension arthroplasty, with an overall mean follow-up period of 13.3 years. Evaluation with disability of arm and shoulder scores, pain via visual analogue scale and range of motion (radial and palmar abduction, and opposition) indicated no significant difference. However, the cohort with a surviving prosthesis showed significantly better subjective grip strength (p = 0.04). Complications occurred in 23 of the 37 thumbs in the prosthesis group compared with two in the resection-suspension arthroplasty patients. Seventeen prostheses required revision. At revision operations, we observed local signs of metallosis in 15 of 17 cases. The patients receiving resection-suspension arthroplasty were more satisfied with their treatment (p = 0.003). Therefore, we cannot recommend the implantation of Elektra® prosthesis and we speculate that the key problem of aseptic cup loosening is a result of the metal-on-metal bearing. Level of evidence: III [ABSTRACT FROM AUTHOR]

Background: There has been a shift in microsurgical education towards simulation training. Hence a number of training programs are being proposed to educate aspiring microsurgeons. However, it is challenging to master the skill of microsurgery and no program has proposed a fully satisfactory training model to date. Therefore, we present an innovative course concept and assess the participants' feedback., Methods: Being offered a four-step modular curriculum, participants can tailor their program to their individual needs and reinforce specific aspects of their training. The program is characterised by exercises ranging from basic techniques performed on avital biologic models to specific surgical techniques performed on human anatomic specimens. In our feedback questionnaire we ask participants to evaluate the parameters "course design", "expectations" and "overall satisfaction" based on a Likert scale with 5 items (100 %, 75 %, 50 %, 25 % and 0 %)., Results: From 2015 to 2017, 274 students completed and evaluated individual courses. The average values exceeded 90 % for all three parameters., Discussion: In conclusion, we have developed and evaluated an innovative training program with a constantly high satisfaction rate and a rising number of participants, thus contributing to the advancement of microsurgical skills in Central Europe., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

The present study compares 34 patients with thumb carpometacarpal osteoarthritis (37 thumbs) treated with the Elektra® prosthesis, with 18 patients (18 thumbs) treated with resection-suspension arthroplasty, with an overall mean follow-up period of 13.3 years. Evaluation with disability of arm and shoulder scores, pain via visual analogue scale and range of motion (radial and palmar abduction, and opposition) indicated no significant difference. However, the cohort with a surviving prosthesis showed significantly better subjective grip strength ( p   =  0.04). Complications occurred in 23 of the 37 thumbs in the prosthesis group compared with two in the resection-suspension arthroplasty patients. Seventeen prostheses required revision. At revision operations, we observed local signs of metallosis in 15 of 17 cases. The patients receiving resection-suspension arthroplasty were more satisfied with their treatment ( p   =  0.003). Therefore, we cannot recommend the implantation of Elektra® prosthesis and we speculate that the key problem of aseptic cup loosening is a result of the metal-on-metal bearing. Level of evidence: III.