Total Wrist Arthroplasty With a New Design: 20 Cases With 8-Year Follow-Up

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI:10.1016/j.jhsa.2023.08.004

Daniel Reiser MD, PhD , Per Fischer MD, PhD , Kurt Pettersson MD, PhD , Per Wretenberg MD, PhD , Marcus Sagerfors MD, PhD

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引用次数: 0

Abstract

Purpose

Total wrist arthroplasty (TWA) is an established motion-preserving alternative to arthrodesis in the treatment of wrist arthritis, but post-TWA complications requiring additional surgery remain an issue. A new TWA design has been proposed. The purpose of this study was to report the outcome of a cohort study of 20 patients who underwent surgery using the new TWA design.

Methods

Patients were assessed before surgery and at 1, 2, and 8 years after surgery for visual analog scale (VAS) pain scores, wrist range of motion, hand grip strength, and patient-reported outcome measures (PROMs). Radiographic examination was conducted for evidence of prosthetic loosening. Reasons for revision were analyzed.

Results

In total, 24 reoperations were performed, including 12 revisions in 6 patients. Patient-reported outcome measures improved significantly at the 2-year follow-up compared with preoperative values. Hand grip strength, wrist extension, and VAS pain scores improved significantly at the 2-year follow-up. No radiographic loosening of the components was observed, but backing out of the carpal screws was noted in 16 of the 20 cases.

Conclusions

The new TWA resulted in improved VAS pain scores, PROMs, wrist extension, and hand grip strength. The high frequency of reoperation is a concern, and modification of the implant is needed.

Type of study/level of evidence

Therapeutic IV.

查看原文本刊更多论文

新设计全腕关节置换术20例，随访8年。

目的:全腕关节置换术(TWA)是关节融合术治疗腕关节炎的一种成熟的保留运动的替代方法，但TWA后的并发症需要额外的手术仍然是一个问题。提出了一种新的TWA设计方案。本研究的目的是报告20例采用新TWA设计的手术患者的队列研究结果。方法:术前、术后1年、2年和8年对患者进行视觉模拟评分(VAS)疼痛评分、手腕活动范围、手部握力和患者报告的结果测量(PROMs)。影像学检查证实假体松动。分析了修改的原因。结果:6例患者共进行了24次再手术，其中12次翻修。与术前相比，患者报告的结果在2年随访中显著改善。在2年的随访中，手部握力、手腕伸展和VAS疼痛评分显著改善。x线片未观察到组件松动，但20例中有16例出现腕螺钉退出。结论:新的TWA改善了VAS疼痛评分、PROMs、手腕伸展和手部握力。再手术的高频率是一个问题，并且需要对种植体进行修改。研究类型/证据水平:治疗性IV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.