This retrospective study evaluated 69 Swanson trapezium replacements performed between 1990 and 2009 for trapeziometacarpal osteoarthritis in 58 patients. Pain and function were assessed using the Michigan Hand Questionnaire (MHQ) and the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Patients had a mean age of 62 years at the time of surgery, with a mean time of 7.7 years from time of surgery to completion of the follow-up interview. The results showed good relief of pain and function with no significant deterioration with time from surgery. There were no gender differences or differences by age. The only differences observed were that those patients following surgery on a dominant hand indicated higher activities of daily living and work related activities. The authors conclude silicone trapezium replacement remains a good option for patients with painful trapeziometacarpal osteoarthritis that has not responded to non-operative treatment.