Trapezium anatomy as a radiographic reference for optimal cup orientation in total trapeziometacarpal joint arthroplasty

2016 ◽  
Vol 41 (9) ◽  
pp. 939-943 ◽  
Author(s):  
J. Duerinckx ◽  
P. Caekebeke
Keyword(s):  
Postoperative Complications ◽  
Range Of Motion ◽  
Total Joint Arthroplasty ◽  
Articular Surface ◽  
Joint Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Implant Position ◽  
Component Loosening

In trapeziometacarpal arthroplasty, correct implant position may be necessary to prevent complications such as dislocation, component loosening and premature wear. The metacarpal stem more easily fits anatomically. However, the cup in the trapezium is not anatomical and guidelines for its orientation are not uniformly defined. We determined the centre of the range of motion of the trapeziometacarpal joint in 30 healthy patients on postero–anterior and lateral radiographs and its relationship to the proximal articular surface of the trapezium. Our study suggests that in thumb carpo-metacarpal total joint arthroplasty, the prosthetic cup in the trapezium should be placed parallel to the proximal articular surface of the trapezium and combined with a metacarpal neck with 7° palmar offset. This should optimize arthroplasty ranges of motion and may minimize the risk of postoperative complications. Our study provides a reference for the surgeon to check correct cup alignment intra-operatively with fluoroscopy.

Can surgical guidelines minimize complications after Maïa® trapeziometacarpal joint arthroplasty with unconstrained cups?

2017 ◽  
Vol 43 (4) ◽  
pp. 420-425 ◽  
Author(s):  
Pieter Caekebeke ◽  
Joris Duerinckx
Keyword(s):  
Joint Arthroplasty ◽  
Radiological Outcome ◽  
Medium Term ◽  
Trapeziometacarpal Joint ◽  
Level Of Evidence ◽  
Implant Position ◽  
Component Loosening ◽  
Surgical Guidelines ◽  
Cup Position

The most important complications of trapeziometacarpal arthroplasty are dislocation and component loosening. Incorrect cup position is often a contributing factor. Intra-operative guidelines to optimize cup orientation have recently been described. We evaluated the functional and radiological outcome of 50 Maïa® trapeziometacarpal prostheses that were implanted according to these guidelines. The minimum follow-up was 56 months. No constrained cups were used. Functional outcome was good to excellent. No spontaneous dislocations occurred. No radiological signs of loosening were observed. There was one case of premature wear. The survival rate was 96% (95% confidence interval 85 to 99%) at a mean of 65 months, with two prosthesie removed for posttraumatic trapezial fractures. This study shows that correct implant position can lead to reliable medium-term results after trapeziometacarpal joint arthroplasty. Level of evidence: IV

The effect of cup orientation on stability of trapeziometacarpal total joint arthroplasty: a biomechanical cadaver study

2019 ◽  
Vol 44 (7) ◽  
pp. 708-713 ◽  
Author(s):  
Annelien Brauns ◽  
Pieter Caekebeke ◽  
Joris Duerinckx
Keyword(s):  
Range Of Motion ◽  
Joint Replacement ◽  
Total Joint Arthroplasty ◽  
Total Joint Replacement ◽  
Articular Surface ◽  
Three Dimensional ◽  
Cadaver Study ◽  
Joint Arthroplasty ◽  
Joint Stability ◽  
Prosthetic Joint

It has been suggested that the cup of a trapeziometacarpal total joint replacement should be positioned parallel with the proximal articular surface of the trapezium to align it with the centre of motion. This would diminish the chance of dislocation. The goal of this study was to test this idea biomechanically. A linked trapeziometacarpal prosthesis was implanted in seven cadaver hands and combined with three-dimensional printed trapezium cups in 17 different orientations. For every combination, stability of the prosthesis was assessed through its entire passive range of motion. Dorsal inclination of the cup relative to the proximal articular surface increased the risk of dislocation with thumb flexion and opposition. The risk of dislocation was also increased with lateral or medial inclination of the cup exceeding 20°. Our results demonstrate that cup orientation is an important factor in prosthetic joint stability. Cup placement parallel to the proximal articular surface is ideal.

scholarly journals Impact of Osteoarthritis and Total Joint Arthroplasty on the Kinematics of the Trapeziometacarpal Joint: A Pilot Study

2018 ◽  
Vol 43 (4) ◽  
pp. 382.e1-382.e10 ◽  
Author(s):  
Priscilla D’Agostino ◽  
Benjamin Dourthe ◽  
Faes Kerkhof ◽  
Evie E. Vereecke ◽  
Filip Stockmans
Keyword(s):  
Pilot Study ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Trapeziometacarpal Joint

The Effect of Smoking on Thirty-Day Postoperative Complications After Total Joint Arthroplasty: A Propensity Score-Matched Analysis

2018 ◽  
Vol 33 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Shawn Sahota ◽  
Francis Lovecchio ◽  
Ryan E. Harold ◽  
Matthew D. Beal ◽  
David W. Manning
Keyword(s):  
Postoperative Complications ◽  
Propensity Score ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty

Can total joint arthroplasty be safely performed in patients with chronic kidney disease?

2020 ◽  
Author(s):  
Meng Fan ◽  
Kai Sun ◽  
Wenxue Jaing
Keyword(s):  
Postoperative Complications ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Vein Thrombosis ◽  
Knowledge Infrastructure ◽  
Increased Risk ◽  
Statistical Heterogeneity ◽  
Deep Vein

BACKGROUND: Patients suffered from chronic kidneydisease are at greater risk of perioperative and postoperative complications. Actually there is no systerm review study demonstrating advantages of total joint arthroplasty can be safely performed in patients with chronic kidney disease.METHODS: Literature search was performed inPubMed, Embase, Web of Science, China National Knowledge Infrastructure(CNKI),Wanfang and Cochrane Library for information from the earliest date of data collection to September 2018. Studies comparing the perioperative, postoperative outcomes of No-CKD with those of CKD patients were included. Statistical heterogeneity was quantitatively evaluated by X2 test with the significance set P<0.10 or I2 > 50%.RESULTS:Three papers consisting of 38,209 patients were included (35,363 No-CKD patients; 2,846 CKD patients). The results showed that CKD was related to a greater increase in postoperative infection rate, deep vein thrombosis, re-admission and mortality(P<0.1). No differences inlength of surgery, length of stay, pulmonary embolism and revision (P>0.10).CONCLUSIONS:Compared with No-CKD patients, CKD patients demonstrated an increased risk of perioperative and postoperative complications and clear difference about complications between No-CKD and CKD about patients with chronic kidneydisease.

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