[Cup Placement in Thumb Carpometacarpal Joint Prostheses: The Role of the Guidewire].

IF 0.4 4区 医学 Q4 SURGERY
Simeon C Daeschler, Jan Sommer, Thomas Jing Zhi Tu, Sebastian Jaeger, Kevin Knappe, Leila Harhaus, Benjamin Panzram
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引用次数: 0

Abstract

Background: The increasing use of thumb carpometacarpal joint prostheses for advanced CMC 1 (carpometacarpal) joint arthritis reflects the success of the latest prosthesis generations, which has been achieved through their improved functional outcomes and lower complication rates. Precise alignment of the prosthesis cup parallel to the proximal joint surface of the trapezium is essential for stability and the prevention of dislocation. This is a challenging surgical step, particularly for surgeons new to this technique. Despite adequate positioning of the guidewire, misplacements of the cup may occur, necessitating intraoperative revision.

Material and methods: This study examined the deviations in cup and guidewire positioning in thumb carpometacarpal joint prosthesis implantations by inexperienced and experienced surgeons through radiological analysis of 65 prostheses.

Results: Both inexperienced and experienced surgeons achieved precise guidewire positioning with mean deviations of<2.2°. Inexperienced surgeons showed significantly larger cup deviations in the dorsopalmar and lateral view (7.6±6.1° and 7.3±5.9°) compared with experienced surgeons (3.6±2.7° and 3.6±2.5°; p=0.012, p=0.017). The deviation of the cup position exhibited by inexperienced surgeons tends to be in the direction opposite to the initial guidewire position (p<0.0038).

Conclusion: The results highlight the current challenges in cup positioning depending on a surgeon's level of experience, questioning the reliability of the current guidewire placement.

[拇指腕掌关节假体中的髋臼杯置入:导丝的作用]。
背景:越来越多的拇指腕掌关节假体被用于治疗晚期 CMC 1(腕掌)关节炎,这反映了最新一代假体的成功,其功能效果更好,并发症发生率更低。假体杯与腕骨近端关节面平行的精确对位对于保持稳定和防止脱位至关重要。这是一个具有挑战性的手术步骤,尤其是对于初次使用这种技术的外科医生来说。尽管导丝已充分定位,但仍可能发生髋臼杯错位的情况,因此必须在术中进行翻修:本研究通过对 65 例假体进行放射学分析,研究了缺乏经验的外科医生和经验丰富的外科医生在拇指腕掌关节假体植入手术中假体杯和导丝定位的偏差:结果:经验不足的外科医生和经验丰富的外科医生都实现了精确的导丝定位,其平均偏差为:结果表明,根据外科医生的经验水平,目前在假体杯定位方面存在挑战,这对目前导丝定位的可靠性提出了质疑。
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
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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