## 4 Discussion  
The treatment of TMJ OA continues to be a subject of debate, with various surgical techniques detailed in the literature, including fusion, total trapeziectomy with or without ligament reconstruction, tendon interposition, arthroplasty, and joint replacement. However, the gold standard of care remains unclear [17; 18; 19; 20]. The literature could not demonstrate any technique that conferred benefits over other techniques in terms of pain and physical function because the studies available were of poor quality [21]. Joint arthroplasty demonstrated better results than trapeziectomy procedures in terms of strength and range of motion [22]. [PERSON] et al. reported MHQ scores in their study and found no statistically significant differences between total joint arthroplasty and trapeziectomy [23]. However, patients who underwent an arthroplasty returned to work sooner [23]. The main findings of this study indicate that both the dual-mobility prosthesis for TMJ OA and AST were effective in improving postoperative clinical, functional, and  
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline  & \multicolumn{2}{c}{**Group A (AST Procedure)**} & \multicolumn{1}{c}{\(p\)**-Value**} & \multicolumn{2}{c}{**Group B (Arthroplasty)**} & \multicolumn{1}{c}{\(p\)**-Value**} \\ \cline{2-6}  & **Preoperative** & \multicolumn{2}{c}{**Post-Surgery**} & \multicolumn{2}{c}{**Preoperative**} & \multicolumn{2}{c}{**Post-Surgery**} & \\  & & **(3-6-12-24 Months)** & & & **(3-6-12-24 Months)** & & \\ \hline \multirow{4}{*}{DASH} & \multirow{4}{*}{71.2 \(\pm\) 4.4} & 25.3 \(\pm\) 5.4 & \textless{}0.05 & & 28.9 \(\pm\) 5.1 & \textless{}0.05 \\  & & 18.2 \(\pm\) 4.8 & \textless{}0.05 & & 19.8 \(\pm\) 4.7 & \textless{}0.05 \\  & & 12.1 \(\pm\) 5.1 & \textless{}0.05 & & 15.0 \(\pm\) 4.3 & \textless{}0.05 \\  & & 9.4 \(\pm\) 6.2 & \textless{}0.05 & & 12.3 \(\pm\) 4.2 & \textless{}0.05 \\ \hline \multirow{4}{*}{MHQ} & \multirow{4}{*}{67.2 \(\pm\) 5.7} & 75.3 \(\pm\) 6.2 & \textless{}0.05 & & 76.8 \(\pm\) 7.3 & \textless{}0.05 \\  & & 81.4 \(\pm\) 6.5 & \textless{}0.05 & & 82.4 \(\pm\) 8.1 & \textless{}0.05 \\  & & 85.6 \(\pm\) 6.8 & \textless{}0.05 & & 88.3 \(\pm\) 8.7 & \textless{}0.05 \\  & & 89.4 \(\pm\) 7.3 & \textless{}0.05 & & 91.2 \(\pm\) 9.3 & \textless{}0.05 \\ \hline \multirow{4}{*}{VAS} & \multirow{4}{*}{7.2 \(\pm\) 3.3} & 2.2 \(\pm\) 1.3 & \textless{}0.05 & & 1.2 \(\pm\) 0.8 & \textless{}0.05 \\  & & 2.0 \(\pm\) 0.6 & \textless{}0.05 & & 1.1 \(\pm\) 0.9 & \textless{}0.05 \\  & & 1.8 \(\pm\) 0.5 & \textless{}0.05 & & 0.3 \(\pm\) 0.7 & \textless{  
radiological outcomes in patients with advanced trapeziometacarpal joint osteoarthritis (TMJ OA). Although some differences were observed in the outcomes, they were not statistically significant, supporting the secondary findings of this study. Therefore, TMJ prosthesis treatment is a safe treatment option for TMJ OA. The comparative analysis revealed that both procedures significantly reduced DASH and VAS scores three months after surgery. These findings align with the established benefits of both techniques in providing pain relief and improving function [23]. The ROM improvements were notable in both groups, with Group B showing a slightly higher increase than Group A. This finding suggests that while both techniques are effective, dual-mobility prostheses may offer a marginal advantage in restoring joint mobility. [PERSON] et al. stated that joint replacement should be preferred to interposition arthroplasty as treatment for rhizarthrosis, opting for the latter in cases of prosthetic replacement complications or scaphoid-trapezium-trapezoid osteoarthritis [24]. [PERSON] compares the outcomes of total basal joint replacement and tendon interposition for treating thumb basal joint osteoarthritis, highlighting that joint replacement leads to faster pain relief, stronger grip, improved range of motion, and quicker recovery, with no increased risk of complications compared to tendon interposition [25].