A retrospective review of long-term follow-up of Niebauer trapeziometacarpal arthroplasty for treatment of disabling arthritis of the basal joint was performed. Thirty implants in 27 patients were reviewed, with an average follow-up of 9 years (minimum, 4 years). All surgical procedures were performed by the senior author. Eighty-eight percent of the patients were subjectively pleased and would undergo the procedure again. Postoperative subluxation occurred in 83% of the patients. This was not painful unless the prosthesis dislocated. Subluxation increased with time. One case of silicone synovitis necessitated implant removal; however, this was also after removal of a previous Eaton prosthesis. In the light of our results, we believe that the Niebauer trapeziometacarpal arthroplasty is a worthwhile procedure with a rare incidence of particulate synovitis. In 24 of 27 patients, pain was relieved and satisfactory motion and stability were achieved.