Bioabsorbable poly-L/D-lactide (96/4) scaffold arthroplasty as a salvage procedure in the metacarpophalangeal joint

Author(s):  
Raffael Labèr ◽  
Michael Oyewale ◽  
Daniel B. Herren
1995 ◽  
Vol 20 (2) ◽  
pp. 125-136 ◽  
Author(s):  
D. J. BEEVERS ◽  
B. B. SEEDHOM

The clinical results of past and current hinge, flexible and third generation designs of MP prosthetic joints are reviewed. The hinged prostheses did not achieve acceptable short term clinical results while the silastic and third generation prostheses provided good results with correction of deformity and adequate range of motion (ROM). These good short term results did, however, get progressively worse with the recurrence of deformities and loss of ROM. It is evident that while most of the existing prostheses can relieve pain and restore appearance, none provide the degree of stability and ROM that is required to restore normal function to the MP joint. The moderate results could be partly due to the stage of the disease at which the surgery is carried out. At present, surgery on patients with rheumatoid arthritis is undertaken at a stage in the disease where the muscles and the ligaments surrounding the joint, and the bone, are generally in a poor condition. Surgery at this stage is really only a salvage procedure.


2015 ◽  
Vol 35 (02) ◽  
pp. 83-89
Author(s):  
R. Scholz
Keyword(s):  

ZusammenfassungDie endoprothetische Versorgung des Ellenbogengelenkes zählt zu den eher seltenen, technisch anspruchsvollen und komplikationsbehafteten Verfahren in der Kunstgelenkchirurgie. Ihr Einsatz beschränkt sich, von seltenen Ausnahmeindikationen abgesehen, auf die stark schmerzhaften Funktionseinschränkungen bei fortgeschrittenen, zumeist sekundären Cubitalarthrosen und ausgeprägten traumatischen Schäden. Andererseits ist sie bei hochgradiger Gelenkzerstörung nach ausgeschöpfter gelenkerhaltender Therapie weitgehend alternativlos. Hinsichtlich der Implantate werden heute überwiegend halb -gekoppelte Systeme verwendet, wohingegen die in der Vergangenheit in vergleichbarer Anzahl implantierten ungekoppelten Endoprothesensysteme an Bedeutung verloren haben. In den vergangenen Jahren sind erste Ansätze technischer Neuerungen für die Entwicklung modularer Systeme entstanden. Dennoch muss häufiger als an anderen Gelenken nach Versagen der Endoprothese auf individuell angefertigte Sonderimplantate zurückgegriffen werden. Arthrodesen oder Resektions-Interpositions-Arthroplastiken sind als Salvage-Procedure nur selten sinnvoll möglich und oft mit erheblichen funktionellen Einschränkungen verbunden. Sie stellen somit keine wirklichen Alternativen zur Revisions -alloarthroplastik dar. Ein besonders großes Problem ist in einer septischen Lokalsituation zu sehen.


Author(s):  
Xiang Qian Shi ◽  
Ho Lam Heung ◽  
Zhi Qiang Tang ◽  
Kai Yu Tong ◽  
Zheng Li

Stroke has been the leading cause of disability due to the induced spasticity in the upper extremity. The constant flexion of spastic fingers following stroke has not been well described. Accurate measurements for joint stiffness help clinicians have a better access to the level of impairment after stroke. Previously, we conducted a method for quantifying the passive finger joint stiffness based on the pressure-angle relationship between the spastic fingers and the soft-elastic composite actuator (SECA). However, it lacks a ground-truth to demonstrate the compatibility between the SECA-facilitated stiffness estimation and standard joint stiffness quantification procedure. In this study, we compare the passive metacarpophalangeal (MCP) joint stiffness measured using the SECA with the results from our designed standalone mechatronics device, which measures the passive metacarpophalangeal joint torque and angle during passive finger rotation. Results obtained from the fitting model that concludes the stiffness characteristic are further compared with the results obtained from SECA-Finger model, as well as the clinical score of Modified Ashworth Scale (MAS) for grading spasticity. These findings suggest the possibility of passive MCP joint stiffness quantification using the soft robotic actuator during the performance of different tasks in hand rehabilitation.


2017 ◽  
Vol 22 (01) ◽  
pp. 35-38 ◽  
Author(s):  
Eichi Itadera ◽  
Takahiro Yamazaki

We developed a new internal fixation method for extra-articular fractures at the base of the proximal phalanx using a headless compression screw to achieve rigid fracture fixation through a relatively easy technique. With the metacarpophalangeal joint of the involved finger flexed, a smooth guide-pin is inserted into the intramedullary canal of the proximal phalanx through the metacarpal head and metacarpophalangeal joint. Insertion tunnels are made over the guide-pin using a cannulated drill. Then, a headless cannulated screw is placed into the proximal phalanx. All of five fractures treated by this procedure obtained satisfactory results.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fausto Biancari ◽  
Giovanni Mariscalco ◽  
Hakeem Yusuff ◽  
Geoffrey Tsang ◽  
Suvitesh Luthra ◽  
...  

Abstract Background Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient’s conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Methods Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient’s comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. Discussion The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD. Trial registration ClinicalTrials.gov Identifier: NCT04831073.


2006 ◽  
Vol 31 (7) ◽  
pp. 1193-1196 ◽  
Author(s):  
J. Woodfin Kennedy ◽  
Lesley K. Wong ◽  
Behrooz Kalantarian ◽  
Leslie Turner ◽  
Cauley W. Hayes

2021 ◽  
pp. 175319342098185
Author(s):  
Xia Fang ◽  
Ping-tak Chan ◽  
Shengbo Zhou ◽  
Xinyi Dai ◽  
Ruiji Guo ◽  
...  

Correction of unequal radial polydactyly in which neither thumb duplicates possess both well-developed proximal and distal components, remains challenging. Current techniques using on-top plasty techniques require circumferential incisions, often resulting in postoperative swelling and dorsal scars. We described our experience using a volar approach to achieve better aesthetic and functional results. Twenty-one patients underwent this surgery between 2008 and 2018, with a mean follow-up of 5.1 years. The mean flexion–extension arc for the metacarpophalangeal joint was 75° and that of the interphalangeal joint was 43°. Mean percentage of key, tripod and tip pinch strength were 77%, 79% and 77%, respectively, when compared with the contralateral side. The Vancouver Scar Scale showed an average score of 1.2. We conclude from our study that the volar approach to on-top plasty is a good technique for the correction of unequal radial polydactyly, with good functional and aesthetic results. Level of evidence: IV


2021 ◽  
pp. 175319342110177
Author(s):  
Daniel B. Herren ◽  
Hajime Ishikawa ◽  
Marco Rizzo ◽  
Mark Ross ◽  
Michael Solomons

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.


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