Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Francesco Smeraglia ◽  
Sergi Barrera-Ochoa ◽  
Gerardo Mendez-Sanchez ◽  
Morena A. Basso ◽  
Giovanni Balato ◽  
...  
Keyword(s):  
Young Patients ◽  
Hand Surgery ◽  
Dash Score ◽  
Level Of Evidence ◽  
Interpositional Arthroplasty ◽  
Trapeziometacarpal Osteoarthritis ◽  
Select Group ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Surgical Treatments

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97–144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV

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

scholarly journals Chondrosarcoma of bone in children and adolescents

2020 ◽  
Vol 14 (4) ◽  
pp. 330-334
Author(s):  
Yoichi Kaneuchi ◽  
Tomohiro Fujiwara ◽  
Yusuke Tsuda ◽  
Shinichirou Yoshida ◽  
Jonathan D. Stevenson ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Young Patients ◽  
Good Prognosis ◽  
Level Of Evidence ◽  
Biological Behaviour ◽  
Children And Adolescent ◽  
Grade Ii ◽  
Surgical Treatments ◽  
Ray Amputation

Purpose Chondrosarcomas typically present in adults during the fifth to seventh decades and are rare in young patients. The biological behaviour and oncological outcomes may be different in children and adolescents. Methods We retrospectively evaluated the outcomes of all patients with chondrosarcoma of bone who were younger than 18 years of age at the time of diagnosis and were treated at our centre between 1995 and 2018. Results The 15 consecutive patients studied included nine male and six female cases, with a mean age at diagnosis of 13 years (7 to 17). The median follow-up was 117 months (30 to 277). The tumours were primary and secondary in ten and five patients, respectively. The tumours were central in 13 and surface in two patients. The tumour locations were the humerus in five, digits in five, femur in three, radius in one and pelvis in one patient. The histological grades were grade I in seven, grade II in seven and grade III in one patient. The surgical treatments were limb salvage in ten patients and ray amputation in five patients. The surgical margins were wide in eight, marginal in two and intralesional in five patients. All the patients were alive and continuously free of disease at the time of the last follow-up. No patient developed metastases or local recurrence. Conclusion Chondrosarcoma of bone in children and adolescent patients has a very good prognosis and is less aggressive compared with published outcomes in older patients. 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

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.

Hemiarthroplasty for Trapeziometacarpal Arthritis – A Useful Alternative?

2003 ◽  
Vol 28 (1) ◽  
pp. 80-85 ◽  
Author(s):  
P. M. PHALTANKAR ◽  
P. A. MAGNUSSEN
Keyword(s):  
Hand Function ◽  
Young Patients ◽  
Titanium Implant ◽  
Clinical Results ◽  
Radiographic Loosening ◽  
Trapeziometacarpal Osteoarthritis ◽  
Good Pain Relief ◽  
Trapeziometacarpal Joint Osteoarthritis

We performed hemiarthroplasty using the Swanson titanium implant for treatment of isolated and advanced trapeziometacarpal joint osteoarthritis Nineteen implants were placed in 18 patients (mean age: 57 years) between 1995 and 1999. One joint required revision and conversion to trapeziectomy. Eighteen joints in 17 patients were evaluated with a mean follow-up period of 34 (range, 14–60) months. Good pain relief was noted in 13 hands. All patients had good hand function as scored using validated questionnaires. Radiographic loosening occurred with five implants and trapezial wear in ten joints. Though radiographic loosening or trapezial wear did not correlate with less satisfactory clinical results, failure of the implant is a concern in the long term. Preliminary results indicate that hemiarthroplasty can be a useful treatment alternative in selected, relatively young patients with isolated trapeziometacarpal osteoarthritis and good bone stock. Good motion and stability can be preserved Failures can be effectively salvaged by trapeziectomy.

High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis

2015 ◽  
Vol 41 (3) ◽  
pp. 322-327 ◽  
Author(s):  
J. K. Thillemann ◽  
T. M. Thillemann ◽  
B. Munk ◽  
K. Krøner
Keyword(s):  
Rating Scale ◽  
Revision Rate ◽  
Numerical Rating Scale ◽  
Elevated Serum ◽  
Consecutive Series ◽  
Dash Score ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Thumb Carpometacarpal

We retrospectively evaluated a consecutive series of 42 Motec thumb carpometacarpal total joint arthroplasties. The primary endpoint was revision with implant removal and trapeziectomy. At follow-up the disability of the arm shoulder and hand (DASH) score, pain on numerical rating scale at rest and with activity and serum chrome and cobalt concentrations were assessed for both unrevised and revised patients. At a mean follow-up of 26 months, 17 patients had been revised. The 2 year cumulative revision rate was 42% (95% CI, 28–60%). The DASH score and pain scores at rest and with activity were comparable between the patients whose thumbs remained unrevised and those revised. Patients with elevated serum chrome and cobalt levels had significantly higher DASH and pain scores, but elevated levels were not associated with revision. The revision rate in this study is unacceptably high. However, pain and DASH scores after revision are acceptable and comparable with patients with non-revised implants. Level of evidence: IV

Clinical, radiological and patient-rated outcome comparison between total and partial ulnar head implants

2021 ◽  
pp. 175319342110484
Author(s):  
Lea Estermann ◽  
Lisa Reissner ◽  
Andrea B. Rosskopf ◽  
Andreas Schweizer ◽  
Ladislav Nagy
Keyword(s):  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Joint Arthroplasty ◽  
Dash Score ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Outcome Comparison ◽  
Pain At Rest

This study aimed to analyse the clinical and radiological outcomes after ulnar head replacement and to compare partial and total ulnar head implants. Twenty-two patients with 23 implants were available with a mean follow-up time of 7 years (range 1.3 to 17) after distal radioulnar joint arthroplasty. At the final follow-up, patients had a low level of pain at rest and during effort, a median Disabilities of the Arm, Shoulder, and Hand (DASH) score of 12 and Patient-Rated Wrist Evaluation score of 12 with partial ulnar head implants, and scores of 20 and 22 in total ulnar head implants, respectively. While the range of motion in patients with partial ulnar head implants was slightly reduced in comparison with the preoperative condition and to the patients with total ulnar head implants, there was a tendency to a higher grip strength and rotational torque. Both types of prosthesis showed sigmoid notch resorptions and resorptions around the neck. We conclude that the results after partial ulnar head replacement do not significantly differ from the total ulnar head implants in many aspects. Level of evidence: III

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.

Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 465-469 ◽  
Author(s):  
Raphaëlle Dumartinet-Gibaud ◽  
Nicolas Bigorre ◽  
Guy Raimbeau ◽  
Jérome Jeudy ◽  
Yann Saint Cast
Keyword(s):  
Survival Rate ◽  
First Year ◽  
Implant Survival ◽  
Level Of Evidence ◽  
Technical Errors ◽  
Lack Of Information ◽  
Trapeziometacarpal Osteoarthritis ◽  
Long Run ◽  
Lost To Follow Up

In this retrospective study, we report a series of 80 Arpe prostheses for trapeziometacarpal osteoarthritis in 63 patients. Twenty-seven prostheses (20 patients) were lost to follow-up. Twenty-one were revised, eight of them during the first year after operation. The calculated cumulated implant survival rate was 85% at 10 years but could be lower due to the lack of information on the patients lost to follow-up. The number of complications due to technical errors was high; but after we had done 30 cases, the number of early revisions decreased markedly. At follow-up, 23 of 32 thumbs were totally free of pain, and the patients were satisfied with 31 thumbs. We conclude that the implant survival declines progressively in the long run, with a survival rate of 80% after 15 years of follow-up and a further decline thereafter. We also found that this surgery was difficult to master. We advise selecting this implant for thumb trapeziometacarpal osteoarthritis with caution. Level of evidence: IV

A health utility assessment of trapeziectomy with ligament reconstruction and tendon interposition for thumb trapeziometacarpal osteoarthritis

2019 ◽  
Vol 44 (7) ◽  
pp. 722-727
Author(s):  
Johnny Ionut Efanov ◽  
David-Dan Nguyen ◽  
Ali Izadpanah ◽  
Michel Alain Danino ◽  
Patrick Harris
Keyword(s):  
Ligament Reconstruction ◽  
Health Utility ◽  
Health State ◽  
Level Of Evidence ◽  
Trapeziometacarpal Osteoarthritis ◽  
Life Years ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Tendon Interposition ◽  
Utility Measures

Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) for trapeziometacarpal joint osteoarthritis may have both postoperative benefits and complications. This study sought to determine the health state utility outcome measures of trapeziectomy with LRTI. Patients who underwent trapeziectomy with LRTI were invited to complete the brief Michigan Hand Questionnaire and utility questionnaires outcomes using a visual analogue scale , time trade-off and standard gamble. Quality-adjusted life years (QALYs) were derived from these utility measures. For this study 32 patients were recruited, with a mean age of 61. Most patients (27/32) perceived the procedure as successful. Utility measures and QALYs serve the purpose of comparing different surgical procedures in terms of their impact on the quality of life of patients as a function of the benefits and complications of each procedure. In this study, the utility of trapeziectomy with LRTI was less than has been described for open palmar fasciectomy but more than for total wrist arthrodesis. Level of evidence: IV

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