Twenty-nine patients have been studied after trapeziometacarpal total joint replacement with a system of the author's design using a titanium metacarpal component and a polyethylene trapezium component cemented to bone with polymethyl methacrylate. Replacement was performed for arthritis, failure of attempted arthrodesis, previous Silastic or total joint arthroplasty failure, or postparalytic fibrous ankylosis of the joint. Twenty-six patients have achieved a good range of painless motion since the study was initiated in 1974. There have been no cases of implant fracture or infection, but three cases have demonstrated loosening at the cement--bone interface. The results appear to warrant cautious optimism at this time.