Surface replacement trapeziometacarpal joint arthroplasty – early results

2009 ◽  
Vol 34 (6) ◽  
pp. 748-757 ◽  
Author(s):  
A. PENDSE ◽  
A. NISAR ◽  
S. Z. SHAH ◽  
A. BHOSALE ◽  
J. V. FREEMAN ◽  
...  
Keyword(s):  
Joint Arthroplasty ◽  
Dash Score ◽  
Surface Replacement ◽  
Trapeziometacarpal Joint ◽  
Early Results ◽  
Asymptomatic Patients ◽  
The Mean ◽  
Quick Dash ◽  
Tendon Interposition

This study reviews the results of Surface Replacement Trapeziometacarpal (SR TMC, Avanta®, San Diego, CA) total joint arthroplasty. Fifty patients (62 joints) were included in the study. Forty-three patients (54 joints) were seen at final follow up. Seven patients (eight joints) were interviewed over the phone. Seven patients were revised to trapeziectomy and ligament reconstruction with tendon interposition, five for aseptic loosening and two for dislocation. At final follow up, the mean Quick DASH score was 30.4 and the Sollerman Score was 77.3. Radiological review of the surviving 55 joints showed subsidence of four trapezial components in asymptomatic patients. Cumulative survival rate was 91% at 3 years. Eighty-five percent of the patients were satisfied with the outcome of their treatment.

Proximal interphalangeal joint arthroplasty with silicone implants (NeuFlex) by a lateral approach: a series of 51 cases

2011 ◽  
Vol 37 (1) ◽  
pp. 50-55 ◽  
Author(s):  
M. Merle ◽  
F. Villani ◽  
B. Lallemand ◽  
L. Vaienti
Keyword(s):  
Lateral Approach ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Silicone Implants ◽  
Lateral Stability ◽  
Degenerative Osteoarthritis ◽  
The Mean ◽  
Quick Dash

The aim of this study is to assess outcomes of a lateral surgical approach for proximal interphalangeal joint arthroplasty with NeuFlex® silicone implants for primary degenerative osteoarthritis. We reviewed 51 arthroplasties performed on 43 patients. The mean follow up period was 36 months (range 18–42). The average preoperative range of motion (ROM) was 38°. The average postoperative ROM was 63°. In 21/51 (41%) cases, there was an average axial deviation of 17° (range 10–30°). VAS and Quick DASH scores improved. In 5/51 (10%) cases, further surgery was required. Our lateral approach seems to be effective and minimally invasive, providing adequate exposure. Contralateral incision and contralateral ligament reinforcement should be performed, whenever necessary, to improve lateral stability.

The Early Results of the Brunelli Procedure for Trapeziometacarpal Instability

1998 ◽  
Vol 23 (6) ◽  
pp. 758-761 ◽  
Author(s):  
S. N. J. ROBERTS ◽  
J. N. BROWN ◽  
M. G. HAYES ◽  
A. SAIES
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Joint Surface ◽  
Carpometacarpal Joint ◽  
Trapeziometacarpal Joint ◽  
Independent Observer ◽  
Abductor Pollicis Longus ◽  
Early Results ◽  
The Mean

We report the results of Brunelli’s abductor pollicis longus transfer for symptomatic instability of the trapeziometacarpal joint in 15 hands (14 patients) at a mean follow-up of 21 months. Patients were assessed subjectively, and objectively by an independent observer. All but one of the patients were very satisfied with the result of the operation, including the six patients who had significant degeneration of the carpometacarpal joint surface preoperatively. Four patients said they had no pain and the mean pain score overall on a visual analogue scale was 1.2 (out of a maximum of 10). Overall the outcome was rated good or excellent in 11 of the 15 thumbs.

scholarly journals Short- to mid-term outcomes of radial head replacement for complex radial head fractures

2020 ◽  
Vol 23 (4) ◽  
pp. 183-189
Author(s):  
Chung-Sin Baek ◽  
Beom-Soo Kim ◽  
Du-Han Kim ◽  
Chul-Hyun Cho
Keyword(s):  
Heterotopic Ossification ◽  
Radial Head ◽  
Elbow Joint ◽  
Ulnar Neuropathy ◽  
Dash Score ◽  
Radial Head Fractures ◽  
Radial Head Replacement ◽  
The Mean ◽  
Quick Dash

Background: The purpose of the current study was to investigate short- to mid-term outcomes and complications following radial head replacement (RHR) for complex radial head fractures and to identify factors associated with clinical outcomes.Methods: Twenty-four patients with complex radial head fractures were treated by RHR. The mean age of the patients was 49.8 years (range, 19–73 years). Clinical and radiographic outcomes were evaluated for a mean follow-up period of 58.9 months (range, 27–163 months) using the visual analog scale (VAS) score for pain, the Mayo elbow performance score (MEPS), the quick disabilities of the arm, shoulder and hand (Quick-DASH) score, and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, the mean VAS score, MEPS, and Quick-DASH score were 0.6±1.1, 88.7±11.5, and 19.4±7.8, respectively. The mean range of motion was 132.7o of flexion, 4.7o of extension, 76.2o of pronation, and 77.5o of supination. Periprosthetic lucency was observed in six patients (25%). Heterotopic ossification was observed in four patients (16.7%). Arthritic change of the elbow joint developed in seven patients (29.2%). Capitellar wear was found in five patients (20.8%). Arthritic change of the elbow joint was significantly correlated with MEPS (P=0.047). Four cases of complications (16.6%) were observed, including two cases of major complications (one stiffness with heterotopic ossification and progressive ulnar neuropathy and one stiffness) and two cases of minor complications (two transient ulnar neuropathy).Conclusions: RHR for the treatment of complex radial head fractures yielded satisfactory short- to mid-term clinical outcomes, though radiographic complications were relatively high.

scholarly journals Early Results of the A.L.P.S. Proximal Humerus Locking Plate

2018 ◽  
Vol 12 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Miltiadis Argyropoulos ◽  
Matthew Kent
Keyword(s):  
Proximal Humerus ◽  
Open Reduction Internal Fixation ◽  
Dash Score ◽  
Early Results ◽  
Effective Treatment Modality ◽  
Younger Age ◽  
Functional Scores ◽  
Quick Dash ◽  
Locking Screw

Background: Open reduction internal fixation of displaced 3 and 4-part proximal humerus fractures is an effective treatment modality particularly for the younger age group, but it is not without complications. Fixed angled locking screw plates are the mainstay of fixation. The A.L.P.S. Proximal Humerus Plating System is a new implant that has smooth locking pegs in the place of humeral head screws to help reduce glenoid damage in the event of cut-out and is designed to sit low on the humerus in order to reduce the risk of subacromial impingement. Methods: Retrospective analysis of 15 consecutive patients who sustained closed displaced 3-part or 4-part fractures and had fixation surgery using the A.L.P.S. plate. Outcome measures were the time to radiographic and clinical union, Oxford Shoulder Score, quick DASH score and complications. Results: Average follow-up was 31.9 weeks. Union was achieved in 100% of patients with a mean time to union of 15.1 weeks. In terms of function, mean OSS was 33.6 and mean quick DASH was 32.5. There were no instances of AVN. Conclusion: Our preliminary results of 15 patients followed up for a mean of 31.9 weeks show equitable union rates and time to union as well as functional scores compared to other available plating systems. This is the first study to report on this implant to date.

scholarly journals Interposition Arthroplasty Versus Hematoma and Distraction for the Treatment of Osteoarthritis of the Trapeziometacarpal Joint

2016 ◽  
Vol 21 (01) ◽  
pp. 85-91 ◽  
Author(s):  
Massimo Corain ◽  
Nicola Zampieri ◽  
Raffaele Mugnai ◽  
Roberto Adani
Keyword(s):  
Average Distance ◽  
Excellent Result ◽  
Surgical Techniques ◽  
Mean Value ◽  
Dash Score ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Wire Suspension ◽  
Tendon Interposition

Background: Various surgical techniques were reported with excellent result for the treatment of trapeziometacarpal joint arthritis. However, the best treatment option was not defined yet. Methods: This randomized prospective study compared the result of two surgical techniques: tendon interposition arthroplasty (64 patients) and K. wire distraction (56 patients) after trapeziectomy for stage 3 or 4 osteoarthritis of the trapeziometacarpal joint. Results: After a mean follow-up period of 6.8 (range, 3-10) years it was possible to observe a higher rate of pain relief following trapeziectomy with K. wire suspension, but no significant differences in strength, range of motion and DASH score between the two groups. On lateral unloaded radiographs the height of the space between the base of the thumb metacarpal and the scaphoid showed a mean value of 6.5 mm for both groups; the average distance between the metacarpal base and the trapezium was not statistically significant in the two groups. Complications were observed only in patients treated with trapeziectomy and interposition arthroplasty and were represented by tendinitis of the FCR in 15% of cases. Conclusions: We demonstrate that the trapezium excision and bone space distraction technique requires a smaller incision, a shorter surgical time, an easier surgical technique, and a less painful recovery, maintaining overlapping levels of functional restore.

Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal joint osteoarthritis: results after minimum 2 years of follow-up

2014 ◽  
Vol 39 (6) ◽  
pp. 604-610 ◽  
Author(s):  
M. Mariconda ◽  
S. Russo ◽  
F. Smeraglia ◽  
G. Busco
Keyword(s):  
Pinch Strength ◽  
Dash Score ◽  
Trapeziometacarpal Joint ◽  
Interpositional Arthroplasty ◽  
Contralateral Hand ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
The Mean ◽  
A Prospective Study

A prospective study was undertaken to assess the outcomes of a series of patients treated using pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis. We analysed the results of this procedure in 27 trapeziometacarpal joints of 25 patients. The mean follow-up interval was 34 months (range 26–52). The study showed that pyrocarbon interpositional arthroplasty provided excellent pain relief and high patient satisfaction. Overall function, according to disabilities of the arm, shoulder and hand (DASH) score, improved from 48 points preoperatively to 14 points at the last follow-up assessment. Key pinch strength recorded in the operated hands was comparable with the results obtained in the contralateral hand and in healthy individuals from the same population. No further operations were performed in the study group. Partial trapeziectomy with pyrocarbon arthroplasty may prove to be a successful option for the treatment of trapeziometacarpal joint osteoarthritis. Further long-term comparative studies are warranted.

scholarly journals Outcomes of Surface Replacement Proximal Interphalangeal Joint Arthroplasty Using the Self Locking Finger Joint Implant: Minimum Two Years Follow-up

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 637-645 ◽  
Author(s):  
Issei Komatsu ◽  
Yoshiya Arishima ◽  
Hirotomo Shibahashi ◽  
Toshihito Yamaguchi ◽  
Yoshitaka Minamikawa
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Grip Strength ◽  
Joint Arthroplasty ◽  
The Self ◽  
Dash Score ◽  
Surface Replacement ◽  
Vas Score ◽  
Pip Joint

Background: The Self Locking Finger Joint (SLFJ) implant is a new type of surface replacement implant. The purpose of this study was to evaluate midterm clinical outcomes of the proximal interphalangeal (PIP) arthroplasty with the SLFJ implant. Methods: We retrospectively studied 26 PIP joint arthroplasties using the SLFJ implant in 17 patients with osteoarthritis or posttraumatic osteoarthritis. Preoperative and postoperative range of motion, grip strength and key pinch, radiographic findings, and complications were evaluated. The Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS) score, course of pain, and patient satisfaction were obtained. Results: The mean follow-up time was 44 months (range, 24-76 months). The average active PIP joint arc of motion improved from 36° before surgery to 44° after surgery. Grip strength and key pinch showed no statistical difference between preoperative and postoperative assessments. The average DASH score and VAS score improved from 40 to 15 and from 5 to 1, respectively. Overall patient satisfaction was 94%. Ninety percent of implants showed osteointegration, and there were no radiographic signs of migration and loosening. Three joints (12%) showed abnormal heterotopic bone formation. Four joints (15%) had secondary surgery—1 joint needing joint head and socket replacement and 3 joints needing contracture release. Conclusions: Our minimum 2 years of follow-up evaluation of the SLFJ implant PIP joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion. The SLFJ implant showed good osteointegration. Further longer-term prospective studies with various types of currently available implants are needed.

Arthroscopic Thermal Capsulorrhaphy for Palmar Midcarpal Instability

2007 ◽  
Vol 32 (4) ◽  
pp. 411-416 ◽  
Author(s):  
W. T. M. MASON ◽  
D. G. HARGREAVES
Keyword(s):  
Small Diameter ◽  
Functional Improvement ◽  
Dash Score ◽  
Early Results ◽  
The Mean

Midcarpal instability is an uncommon problem in which deficient static and dynamic wrist stabilisers cause sudden, uncontrolled movement of the proximal carpal row. We studied 15 wrists prospectively in 13 patients who underwent arthroscopic thermal capsulorrhaphy for palmar midcarpal instability. Capsulorrhaphy was performed using standard wrist arthroscopic techniques and a small diameter monopolar radiofrequency probe. One hundred percent follow-up was achieved at a mean of 42 (range 14 – 67) months. With regards to instability, all wrists showed improvement or resolution of instability. Functional improvement was confirmed by an improvement in the mean DASH score from 38 pre-operatively to 17 at final follow-up. Our early results show that thermal capsulorrhaphy is effective in reducing the instability symptoms of palmar midcarpal instability.

scholarly journals Ligament Reconstruction of Traumatic Pure Dislocation of Carpometacarpal Joint of the Thumb: A Series of Acute and Chronic Cases

2020 ◽  
Vol 12 (S 01) ◽  
pp. S16-S20
Author(s):  
Farid Najd Mazhar ◽  
Davod Jafari ◽  
Seyed Sajjad Jafari ◽  
Alireza Mirzaei
Keyword(s):  
Grip Strength ◽  
Outcome Measures ◽  
Ligament Reconstruction ◽  
Reconstruction Technique ◽  
Reconstruction Method ◽  
Dash Score ◽  
The Mean ◽  
Quick Dash ◽  
Cmc Joint

Abstract Background Traumatic instability of carpometacarpal (CMC) joint of the thumb without a fracture (pure dislocation of CMC joint) is an uncommon injury, and a universally accepted protocol has not yet been developed for its management. Here, we aim to evaluate the outcome of this injury managed with ligament reconstruction technique, in a series of acute and chronic injuries. Patients and Methods Total nine patients (six acute and three chronic) with pure dislocation of CMC joint who underwent ligament reconstruction surgery were included in this retrospective study. Outcome measures included disabilities of the arm, shoulder, and hand (quick-DASH) questionnaire; visual analog scale (VAS) scoring system; patient-rated wrist/hand evaluation (PRWHE) system; pinch and grip strength; and Kapandji thumb opposition scores. Results The patients’ mean age was 32.55 ± 11.4 years. Their mean follow-up period was 27 ± 12.8 months. The mean postoperative pinch and grip strength was equivalent to 91.5% and 108% of the contralateral hand, respectively. The mean Quick-DASH score was 14.7 ± 19.4. The mean PRWHE score was 18.7 ± 22.4. The mean VAS was 1.1 ± 1.5. The mean Kapandji score was 8.3 ± 1.4. The pinch and grip strength were considerably superior in acute injuries. Degenerative changes were seen in all joints at the latest follow-up. None of our patients needed a revision surgery. Conclusion Ligament reconstruction method could result in favorable outcome in the management of pure dislocation of CMC joint. However, delayed surgery of this injury might adversely affect the outcome measures.

Early Results of Total Cementless Hip Joint Arthroplasty with the Anatomical Stem

2021 ◽  
Vol 23 (3) ◽  
pp. 167-180
Author(s):  
Marek Drobniewski ◽  
Magdalena Krasińska ◽  
Marek Synder ◽  
Andrzej Borowski
Keyword(s):  
Hip Joint ◽  
Functional Results ◽  
Joint Arthroplasty ◽  
Acetabular Cup ◽  
Kaplan Meier ◽  
Early Results ◽  
Long Term Follow Up ◽  
The Mean ◽  
Joint Arthroplasties

Background. The aim of this study is to present the early results of hip joint arthroplasty with the EXCEPTION anatomical stem (BIOMET). Materials and methods. The study enrolled 173 patients (110 women and 63 men) who underwent a total of 190 hip joint arthroplasties with the EXCEPTION anatomical stem. The mean age of the patients at surgery was 58.2 years (range: 28-82 years). The mean follow-up period was 7.3 years (range: 5-10.1 years). Results. Pre-operative Merle d’Aubigne-Postel scores (modified by Charnley) of the study group were poor in all patients. Mean post-operative improvement was 6.7 points. The outcomes were classified as excellent in 131 cases, good in 39, satisfactory in 13 and poor in 7 cases. Poor results were always associated with implant loosening. Heterotopic ossification was noted in 14 cases (7.4%). According to the Kaplan-Meier estimator, 5 years’ survival probability was 96.31% for the whole implant and 99.47% for the stem alone. Conclusions. 1. Our follow-up data (from a mean follow-up period of more than 7 years) indicate that the EXCEPTION anatomical stem affords excellent clinical and functional results. 2. With good surgical technique and in the absence of complications, the risk of aseptic loosening is minimal. 3. Due to the relatively short duration of follow-up, there may be more cases of loosening (mainly of the acetabular cup) over time, requiring regular long-term follow-up.

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