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Wrist arthroplasty

A Completo, J Pereira, A Nascimento, F Almeida
A systematic review of peer reviewed articles has shown that the main cause for wrist arthroplasty revision is carpal and radial prosthetic loosening and instability. To improve arthroplasty outcomes, successive generations of implants have been developed over time. The problem with the current generation of implants is the lack of long-term outcomes data. The aim of the present work was to test the hypothesis that the current generation Maestro WRS implant has a stress, strain and stability behaviour which may be associated with a reduced risk of long-term radial component loosening...
December 16, 2016: Journal of Biomechanics
Haku Iizuka, Yoichi Iizuka, Koichi Okamura, Yukio Yonemoto, Tokue Mieda, Kenji Takagishi
OBJECTIVES: The purpose of this study was to clarify the characteristics of bony ankylosis of the facet joint of the cervical spine in rheumatoid arthritis (RA) patients who required cervical spine surgery, and its relationship to the clinical findings. METHODS: Eighty consecutive RA patients with cervical spine disorder who received initial surgery were reviewed. The occurrence of bony ankylosis of the facet joint of the cervical spine was investigated using computed tomography (CT) before surgery...
December 21, 2016: Modern Rheumatology
R Badge, K Kailash, D R Dickson, S Mahalingam, A Raza, A Birch, D Nuttall, S R Murali, M J Hayton, S Talwalkar, A C Watts, I A Trail
AIMS: The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis. PATIENTS AND METHODS: This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures...
December 2016: Bone & Joint Journal
David H Wei, Paul Feldon
Total wrist arthrodesis remains an important technique in the surgical armamentarium of upper extremity surgeons. The procedure has evolved over time but continues to provide reliable pain relief at the expense of wrist motion. It is indicated for management of a wide variety of upper extremity conditions, including rheumatoid arthritis, posttraumatic osteoarthritis, cerebral palsy, and brachial plexus injuries, and as a salvage technique after failed implant arthroplasty. Recent studies demonstrate high levels of patient satisfaction and good functional outcomes after bilateral wrist fusion...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
Ingo Schmidt
A 51-year-old female patient presented with a carpal giant cell tumor (GCT) of the right capitate bone. The lesion was initially misdiagnosed as having an osteomyelitis. First, the diagnosis of a benign GCT was confirmed by histological examination. Second, an intralesional curettage and packing of the cavity with cancellous iliac crest bone grafts combined with a fusion of the third carpometacarpal (CMC III) joint were carried out. Third, due to a secondary midcarpal osteoarthritis and a secondary scaphoid nonunion, the CMC III joint fusion plate was removed and the midcarpal joint completely excised...
2016: Case Reports in Orthopedics
O Reigstad, T Holm-Glad, R Thorkildsen, C Grimsgaard, M Røkkum
: From 2001 to 2015, 11 wrists in 11 patients with osteoarthritis of the wrist had failed wrist arthroplasties, which were subsequently converted to arthrodesis using intercalated corticocancellous autograft from the iliac crest and fixation with an arthrodesis plate or a customized peg. Clinical and radiological bone union was achieved in all the operated wrists. At final follow-up of ten patients after 6 years, they had a substantial reduction in pain and improvement in daily function and grip strength compared with those before arthrodesis...
October 26, 2016: Journal of Hand Surgery, European Volume
L Reissner, K Böttger, H J Klein, M Calcagni, T Giesen
Range of motion and stability are important outcome parameters to assess function of the distal radioulnar joint (DRUJ), in particular pronation, supination, and weight-lifting capacity. The DRUJ semiconstrained implant developed by Scheker et al is intended to reproduce all the functions of the triangular fibrocartilage complex and the DRUJ. The aim of the study was to investigate the subjective, clinical, and radiographic results in 10 patients after primary implantation of the semiconstrained DRUJ arthroplasty following DRUJ derangement and painful instability, with an average follow-up of 3 years with a special focus on the complications...
November 2016: Journal of Wrist Surgery
Jae Hoon Lee, Duke Whan Chung, Jong Hun Baek, Young Jun Kim, So Young Park
Background Although proximal fibular flaps have been widely applied in wrist arthroplasty, controversy remains regarding which side of the proximal fibula is better for reconstruction of the distal radius. If the articular surface of the proximal fibula shows dorsal tilting, the ipsilateral (right) proximal fibula should be harvested in right wrist arthroplasty because the articular surface of the distal radius normally has volar tilt. This study investigated anatomical similarities between the proximal fibular articular surface and the distal radius articular surface based on morphologic analysis of the proximal fibula using computed tomography (CT)...
October 21, 2016: Journal of Reconstructive Microsurgery
John W Karl, Lauren H Redler, Peter Tang
BACKGROUND: Long-term outcomes of radial head resection for radial head fracture have shown mixed outcomes, depending on the integrity of the soft-tissue stabilizers of the elbow, forearm, and wrist. METHODS: We report a case of a symptomatic delayed proximal migration of the radius after radial head excision for radial neck nonunion which was managed with a staged radial head replacement. Informed consent was obtained from the individual in this case report. RESULTS: At 7 months after radial head replacement, the patient had 90 degrees of forearm supination and 85 degrees of pronation...
2016: Iowa Orthopaedic Journal
Brian D Adams, Ericka A Lawler, Taften L Kuhl
INTRODUCTION: Due to a higher risk for implant loosening, particularly of the distal component, patients with physically demanding lifestyles are infrequently considered for total wrist arthroplasty (TWA). A distal radius hemiarthroplasty may obviate the need for the strict restrictions recommended for patients treated by TWA, thus providing another surgical option for active patients with severe wrist arthritis, especially those with articular degeneration of the lunate facet of the radius, capitate head, or combination of both, who are not typically candidates for traditional motion-preserving procedures...
August 2016: Journal of Wrist Surgery
Eitan Melamed, Bryan Marascalchi, Richard M Hinds, Marco Rizzo, John T Capo
BACKGROUND: Total wrist arthroplasty (TWA) provides the requisite range of motion to accomplish activities of daily living, especially for low-demand patients with bilateral wrist arthritis. However, there are no large epidemiologic studies to evaluate nationwide trends of TWA and wrist fusion (WF). QUESTIONS/PURPOSES: To analyze data collected from the National Inpatient Sample (NIS) to compare utilization, demographic, and outcome data among patients undergoing TWA versus total WF...
August 2016: Journal of Wrist Surgery
Akihiro Fukui, Hideki Yamada, Takashi Yoshii
BACKGROUND: A significant number of patients on long-term treatment and users of biologics complain of wrist pain due to synovial proliferation and arthropathic changes. Synovectomy or joint arthroplasty is often indicated for such patients, but many refuse surgery. For these patients triamcinolone acetonide was injected into the dorsum of the wrist, and evaluated the clinical benefit and safety of the wrist joint. METHODS: We injected triamcinolone acetonide into the dorsum of the wrist...
June 2016: Journal of Hand Surgery Asian-Pacific Volume
Chong Jin Yeo, Levi Philip Morse, Jeganath Krishnan, Gregory Ian Bain
The distal radioulnar joint (DRUJ) allows forearm rotation and load transmission across the wrist. Post-traumatic and degenerative joint disease of DRUJ may cause pain and disability. Deficiency of the soft tissue or bony supports may result in DRUJ instability. Various techniques have been developed to address arthritis and / or instability of the DRUJ. A comprehensive review of the spectrum of surgical techniques and arthroplasty options is presented. The concepts of these procedures are discussed in detail, with a focus on special points of interest to optimise outcomes and to avoid complications...
June 2016: Journal of Hand Surgery Asian-Pacific Volume
Baichuan Wang, Qiang Wu, Jianxiang Liu, Songfeng Chen, Zhicai Zhang, Zengwu Shao
PURPOSE: A giant cell tumor (GCT) of bone presenting in the distal radius is rare, however, when they occur, Campanacci Grade III tumors can present formidable reconstructive challenges. They are associated with a high local recurrence rate with intralesional treatment, therefore approaches to reconstruct the wrist after en bloc resection warrant study. QUESTIONS: We asked: (1) What are the functional outcomes after en bloc resection and reconstruction of the wrist with a unipolar prosthesis in patients with Grade III GCT of the distal radius? (2) What complications occur with use of a unipolar prosthesis in these patients? (3) What are the oncologic outcomes with using en bloc resection and reconstruction with a custom unipolar wrist hemiarthroplasty for Grade III GCTs of the distal radius? METHODS: We retrospectively analyzed 10 patients with Campanacci Grade III GCTs of the distal radius treated by a unipolar prosthesis after wide resection of the tumor between January 2008 and October 2013...
December 2016: Clinical Orthopaedics and related Research
Ilse Degreef
Background The elbow joint is a complex compound articulation, with a linking role within the upper limb kinematics. Its hinge function allows for proper placement of our working instrument (the hand) in the space surrounding us, directed by the shoulder joint. Both reliable mobility and stability are essential elements to allow for consistent bridging of the distance we aim to achieve in common daily activities. Sufficient flexion and extension are required to ensure both the patients' independence and the dignity...
April 2016: Acta Chirurgica Belgica
Gwen Weinstock-Zlotnick, Saurabh P Mehta
STUDY DESIGN: Structured literature synthesis. INTRODUCTION: Hand therapists and researchers have numerous options when selecting outcome measures for patients with wrist pathologies. An evidence-based approach to determining which measures are used most often can inform choices. PURPOSE OF THE STUDY: To describe how frequently outcome measures are used in recent randomized controlled trials of patients with wrist diagnoses. Identifying assessment design and related International Classification of Functioning, Disability and Health (ICF) domains provides additional consideration for selection...
April 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Marcio Aurélio Aita, Daniel Schneider Ibanez, Gabriel Cunha Barbosa Saheb, Rafael Saleme Alves
OBJECTIVE: To measure the quality of life and clinical-functional results from patients diagnosed with osteoarthrosis of the distal radioulnar joint who underwent surgical treatment using the technique of total arthroplasty of the ulna, with a total or partial Ascension(®) prosthesis of the distal ulna. METHODS: Ten patients were evaluated after 12 months of follow-up subsequent to total or partial arthroplasty of the distal ulna. All of them presented post-traumatic osteoarthrosis and/or chronic symptomatic instability of the distal radioulnar joint...
November 2015: Revista Brasileira de Ortopedia
Nicolas de l'Escalopier, Philippe Anract, David Biau
There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance...
June 2016: Annals of Physical and Rehabilitation Medicine
Mehmet Hakan Özsoy, Metin Işık, Abdurrahman Sakaoğulları, Hacı Mustafa Özdemir, Mehmet Yücel, Veysel Ercan Dincel
OBJECTIVE: The purpose of this study was to evaluate the results of a new reconstruction with anconeus interposition arthroplasty in acute multiligamentous elbow injuries with irreparable radial head fractures. METHODS: Five patients (3 males, 2 females) with a mean age of 42.6 years who underwent reconstruction with anconeus arhtroplasty were evaluated. With lateral approach, lateral capsuloligamentous structures were repaired, the radial head was excised, and anconeus interposition arthroplasty was performed...
2016: Acta Orthopaedica et Traumatologica Turcica
Jean-David Werthel, Thierry Dubert
UNLABELLED: Recent studies seem to show that ligament reconstruction with tendon interposition (LRTI) does not provide any benefit over trapezium excision alone; however dorsal subluxation was not measured in these studies. We believe it is logical to perform ligamentoplasty in order to obtain long-term stability and therefore treat dorsal subluxation. Our aim is to verify this hypothesis in an observational prospective study of LRTI using the entire flexor carpi radialis (FCR) tendon...
April 2016: Hand Surgery and Rehabilitation
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