The Moovis® implant for trapeziometacarpal osteoarthritis: results after 2 to 6 years

2020 ◽  
Vol 45 (5) ◽  
pp. 477-482 ◽  
Author(s):  
Antoine Martins ◽  
Sébastien Charbonnel ◽  
Frédéric Lecomte ◽  
Lionel Athlani
Keyword(s):  
Analogue Scale ◽  
Pinch Strength ◽  
Trapeziometacarpal Joint ◽  
Level Of Evidence ◽  
Dual Mobility ◽  
Joint Replacements ◽  
Trapeziometacarpal Osteoarthritis ◽  
Contralateral Hand ◽  
Thumb Motion

In this retrospective study we reviewed the outcomes of 46 trapeziometacarpal joint replacements with the Moovis® prosthesis in 46 patients with painful osteoarthritis. The dual mobility design of this prosthesis aims to reduce prosthetic dislocation and subsidence. At follow-up 2 to 6 years (mean 5 years) after operation, pain was reduced from 6 to 0 on a visual analogue scale from 0 to 10. The scores of the Quick Disabilities of the Arm, Shoulder and Hand questionnaire improved significantly. Thumb motion and grip and pinch strength did not differ significantly from the contralateral hand. There were no radiographical signs of implant subsidence or loosening. No implant required revision. Forty-five patients rated the result as excellent or good. We conclude the Moovis® is a reliable and effective implant at short- to mid-term follow-up. Level of evidence: IV

scholarly journals Pyrocardan Trapeziometacarpal Joint Arthroplasty—Medium-Term Outcomes

2020 ◽  
Vol 9 (06) ◽  
pp. 509-517
Author(s):  
James Logan ◽  
Susan E. Peters ◽  
Ruby Strauss ◽  
Silvia Manzanero ◽  
Gregory B. Couzens ◽  
...  
Keyword(s):  
Case Series ◽  
Postoperative Outcome ◽  
Preoperative Assessment ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Original Series ◽  
Surgery Outcome ◽  
Trapeziometacarpal Osteoarthritis ◽  
Patient Reported

Abstract Objective Pyrocardan trapeziometacarpal interposition implant is a free intra-articular spacer composed of pyrocarbon. This biconcave resurfacing implant, both ligament and bone-stock sparing, is indicated for use in early-to-moderate stage trapeziometacarpal osteoarthritis. It was hypothesized that the postoperative outcome measures of the Pyrocardan implant would be comparable to those seen with ligament reconstruction and tendon interposition (LRTI) surgeries and those reported by the designer of the implant, Phillipe Bellemère, but that strength would be greater than for LRTI. Methods In this prospective case series, 40 Pyrocardan implants were performed in 37 patients. Average age was 58 years (range: 46–71). Patients were assessed preoperatively, 3 months, 6 months, 1 year, 2 years, and beyond (long term) wherever possible. Results There have been no major complications or revision surgeries for the series. Average follow-up was 29 months (range: 12 months–7 years). Twenty-eight joints were assessed at over 2 years post index surgery. Outcome measure scores improved from preoperative assessment to the most recent follow-up equal or greater than 2 years. Average grip strength at 2 years was 30 kg, as compared with 19.6 kg in an age-matched cohort who underwent trapeziectomy and 25 kg in Bellemère's original series of Pyrocardan implants. Conclusions Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis. Patient-reported clinical outcomes were at least equivalent to LRTI and are comparable to Bellemère's original series. Grip and pinch strength appear to be better than LRTI. Level of Evidence This is a Level III, prospective observational cohort study.

Outcomes of cementless joint prosthesis versus tendon interposition for trapeziometacarpal osteoarthritis: a prospective study

2018 ◽  
Vol 44 (2) ◽  
pp. 151-158 ◽  
Author(s):  
Roman Cebrian-Gomez ◽  
Alejandro Lizaur-Utrilla ◽  
Emilio Sebastia-Forcada ◽  
Fernando A. Lopez-Prats
Keyword(s):  
Ligament Reconstruction ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Trapeziometacarpal Osteoarthritis ◽  
The Mean ◽  
A Prospective Study ◽  
Tendon Interposition ◽  
Mid Term Results ◽  
Dash Questionnaire

We compared 84 patients with the Ivory trapeziometacarpal prosthesis versus 62 with ligament reconstruction and tendon interposition arthroplasty performed for osteoarthritis. There were 134 women and 12 men with a mean age of 60 years. Prospective clinical assessment was made using the Quick Disability of the Arm, Shoulder and Hand (DASH) questionnaire, visual analogue scale for pain, range of motion, and grip and pinch strength. The mean follow-up was 4 years (range 2–5). Prosthetic replacement provided significantly better thumb abduction, adduction, pinch strength, QuickDASH, pain relief, satisfaction and a faster return to daily activities and previous work. Revision surgery was required for two patients in the prosthesis group, two for dislocation and one cup loosening, while in the ligament reconstruction group there were no revisions. We conclude that trapeziometacarpal prosthesis provides better mid-term results in terms of function compared with ligament reconstruction and tendon interposition for patients with Stages 2 and 3 osteoarthritis of the trapeziometacarpal joint. Level of evidence: II

Excision of the Trapezium and Interposition Arthroplasty with Gelfoam for the Treatment of Trapeziometacarpal Osteoarthritis

2003 ◽  
Vol 28 (3) ◽  
pp. 242-245 ◽  
Author(s):  
I. NUSEM ◽  
D. R. GOODWIN
Keyword(s):  
Grip Strength ◽  
Index Finger ◽  
Pinch Strength ◽  
Interposition Arthroplasty ◽  
Trapeziometacarpal Joint ◽  
Postoperative Result ◽  
Trapeziometacarpal Osteoarthritis ◽  
Improved Function ◽  
Space Ratio

Excision of the trapezium with Gelfoam interposition was performed in 35 thumbs, 34 of which were evaluated after an average 5 years. Twenty-four patients had unilateral procedures. The follow-up examination included a standardized questionnaire and clinical and radiological examinations. Pain relief was achieved in all cases. The patients considered that 32 of their operated hands had improved function, while two had not improved. All patients were satisfied with the final postoperative result. Adduction of the thumb to the index finger, and opposition to the tip of the little finger was possible in all cases. Weakness, in comparison to the other thumb, of lateral pinch (71%; P=0.0001), tip pinch (74%; P=0.007), and grip strength (85%; P=0.006) were observed. The first web span was preserved in all hands. Calculation of the trapezial space ratio demonstrated only slight, insignificant shortening (7%; P=0.06) of the thumb ray. No significant correlations between the postoperative trapezial space ratio and lateral pinch strength, tip pinch strength, and grip strength were observed. We conclude that excision of the trapezium and Gelfoam interposition has no specific complications and is a reliable surgical treatment for osteoarthritis of the trapeziometacarpal joint.

Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years

2021 ◽  
pp. 175319342110245
Author(s):  
Bruno Lussiez ◽  
Cyril Falaise ◽  
Pascal Ledoux
Keyword(s):  
Prospective Study ◽  
Functional Outcomes ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Dual Mobility ◽  
The Mean ◽  
The Stability ◽  
A Prospective Study ◽  
Score Index

We report the results of a prospective study using a dual mobility trapeziometacarpal prosthesis (Touch®) in 107 patients with a minimum follow-up of 3 years. One-hundred and two patients (95%) were very satisfied or satisfied with the functional outcomes and the mean pain intensity in visual analogue scale decreased from 7.4 to 0.8 ( p < 0.001). Thumb opposition (Kapandji score) index increased from an average of 8.0 to 9.4, while the mean QuickDASH score improved from 38 preoperatively to 20 at follow-up ( p < 0.01). Key-pinch strength improved from 3.5 kg (range 0.5–9.5) to 5.5 kg (range 3.0–11.5). There was a 4.6% rate of complications, including cup loosening and wear of polyethylene, which required revision, but no cases of prosthetic dislocation were seen. Applying the dual mobility principle to trapeziometacarpal arthroplasty may significatively improve the stability of these prostheses. Radiolucent zones around the components of the prostheses are not systematic predictors of future loosening. Level of evidence: IV

Ivory arthroplasty for trapeziometacarpal osteoarthritis: 10-year follow-up

2018 ◽  
Vol 44 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Gino Vissers ◽  
Chul Ki Goorens ◽  
Bert Vanmierlo ◽  
Francis Bonte ◽  
Koen Mermuys ◽  
...  
Keyword(s):  
Long Term Results ◽  
Trapeziometacarpal Joint ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Trapeziometacarpal Osteoarthritis ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Preoperative Status ◽  
The Mean

This prospective study investigates long-term functional outcome after total trapeziometacarpal joint replacement with the Ivory arthroplasty for trapeziometacarpal joint osteoarthritis. Clinical outcome, overall function, pain, and radiologic outcome after a minimum of 10 years were evaluated for 26 Ivory arthroplasty in 24 patients. Two patients had bilateral arthroplasties. The female to male ratio was 22:2, and the mean age was 71 years (range 57–83). The mean follow-up period was 130 months (range 120–142). Overall functioning as defined by the QuickDASH score and visual analogue pain score improved by 50% and 81%, respectively, when compared with the preoperative status. However, these outcomes deteriorated beyond 5 years after surgery. Long-term results suggest the Ivory arthroplasty to be a reliable treatment for trapeziometacarpal osteoarthritis since it improves overall function and reduces pain up to 10 years postoperatively. However, revision within 10 years after surgery was needed in four of 26 cases. Level of evidence: II

Trapeziectomy and ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist

2013 ◽  
Vol 39 (8) ◽  
pp. 833-837 ◽  
Author(s):  
R. Langenhan ◽  
B. Hohendorff ◽  
A. Probst
Keyword(s):  
Analogue Scale ◽  
Ligament Reconstruction ◽  
Pinch Strength ◽  
Dash Score ◽  
Trapeziometacarpal Osteoarthritis ◽  
Osteoarthritis Of The Wrist ◽  
Pain At Rest ◽  
Tendon Interposition ◽  
Median Pain

Isolated osteoarthritis of the scaphotrapeziotrapezoid joint is rather rare compared with thumb trapeziometacarpal osteoarthritis. The aim of this retrospective study was to evaluate the outcome of 15 consecutive patients treated with trapeziectomy/ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist. After a mean follow-up of 54 months, 14 patients (15 wrists) were available for clinical and radiological examination. The median pain intensity was 0 on a 0–10 visual analogue scale, both at rest and with activity, mean grip strength averaged 24 kg, pinch strength 5 kg. The disabilities of the arm, shoulder and hand (DASH) score was 16, and a modified Mayo Wrist Score 84. Correlation between the degree of scaphotrapezoid osteoarthritis and pain at rest, pain with activity, and DASH score was not significant. The findings from our study suggest that trapeziectomy/ligament reconstruction tendon interposition is an effective procedure for treating isolated scaphotrapeziotrapezoid osteoarthritis, and that additional partial trapezoid excision is not necessary.

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.

Two-year outcomes of Elektra prosthesis for trapeziometacarpal osteoarthritis: a longitudinal cohort study

2012 ◽  
Vol 37 (2) ◽  
pp. 130-137 ◽  
Author(s):  
P. Hernández-Cortés ◽  
M. Pajares-López ◽  
M. J. Robles-Molina ◽  
R. Gómez-Sánchez ◽  
M. A. Toledo-Romero ◽  
...  
Keyword(s):  
Cohort Study ◽  
Bone Scan ◽  
Longitudinal Cohort Study ◽  
Pinch Strength ◽  
Trapeziometacarpal Joint ◽  
Longitudinal Cohort ◽  
Radiographic Outcomes ◽  
Trapeziometacarpal Osteoarthritis ◽  
Poor Outcomes

The aim of this study was to evaluate clinical and radiographic outcomes of Elektra® trapeziometacarpal prostheses after 2 years. We present a longitudinal cohort study of 19 prostheses for the treatment of Eaton stage II and III osteoarthritis (mean follow-up of 29 months). QuickDASH score, pinch strength and mobility were determined, and radiographs were analysed. Isotope scans were taken in patients with persistent pain or suspected loosening. Although the QuickDASH score was 69 before and 38 after surgery, nine patients had pain at the trapeziometacarpal joint with radiographic osteolysis around the trapezium component and a positive bone scan uptake at subsequent follow-up. The implant was revised in three of these nine patients and another patient underwent surgery for periprosthetic fracture. Only ten of the 19 implants showed no sign of failure. Most problems derived from the trapezium cup. Because of these poor outcomes after only 2 years, we cannot recommend this implant.

A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis

2016 ◽  
Vol 41 (7) ◽  
pp. 710-718 ◽  
Author(s):  
M. Rubino ◽  
L. Cavagnaro ◽  
V. Sansone
Keyword(s):  
Simple Technique ◽  
Stage Iv ◽  
Pinch Strength ◽  
Dash Score ◽  
Level Of Evidence ◽  
First Ray ◽  
Excision Arthroplasty ◽  
Surgical Treatments ◽  
New Surgical Technique

We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2–6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis. Level of evidence: 4

Scaphoid Excision and Bicolumnar Carpal Fusion with Retrograde Headless Screws

2021 ◽  
Author(s):  
Sebastian Undurraga ◽  
Kendrick Au ◽  
Johanna Dobransky ◽  
Braden Gammon
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Statistical Significance ◽  
Pinch Strength ◽  
Neutral Position ◽  
Level Of Evidence ◽  
Wrist Extension ◽  
Flexion Extension ◽  
Patient Reported

Abstract Background/Purpose Scaphoid excision and partial wrist fusion is used for the treatment of scapholunate advanced collapse/scaphoid nonunion advanced collapse wrist arthritis. The purpose of this study was to report midterm functional and radiographic outcomes in a series of patients who underwent bicolumnar fusion of the lunocapitate and triquetrohamate joints using retrograde headless screws. Methods Twenty-three consecutive patients (25 wrists) underwent surgery with this technique from January 2014 to May 2017 with a minimum follow-up of 1 year. Assessment consisted of range of motion, grip, and pinch strength. Patient-reported outcome measures included disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) scores. Fusion rates and the radiolunate joint were evaluated radiographically. The relationship between wrist range of motion and midcarpal fusion angle (neutral position vs. extended capitolunate fusion angle > 20 degrees) was analyzed. Results Average follow-up was 18 months. Mean wrist extension was 41 degrees, flexion 36 degrees, and radial-ulnar deviation arc was 43 degrees. Grip strength was 39 kg and pinch 9 kg. Residual pain for activities of daily living was 1.6 (visual analog scale). The mean DASH and PRWE scores were 19 ± 16 and 28 ± 18, respectively. Patients with an extended capitolunate fusion angle trended toward more wrist extension but this did not reach statistical significance (p = 0.17). Conclusions With retrograde headless compression screws, the proximal articular surface of the lunate is not violated, preserving the residual load-bearing articulation. Patients maintained a functional flexion–extension arc of motion with grip-pinch strength close to normal. Capitolunate fusion angle greater than 20 degrees may provide more wrist extension but further studies are needed to demonstrate this. Level of Evidence This is a Level IV study.

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