通用2型全腕置换术的中期和长期疗效

Pub Date : 2023-09-21 DOI:10.1055/s-0043-1772714
Adam Truss, Geraint Morris, Seif Sawalha, Mohammad Waseem
{"title":"通用2型全腕置换术的中期和长期疗效","authors":"Adam Truss, Geraint Morris, Seif Sawalha, Mohammad Waseem","doi":"10.1055/s-0043-1772714","DOIUrl":null,"url":null,"abstract":"Abstract Introduction Arthritis of the wrist can lead to severe functionally debilitating pain which, after failed conservative measures, may require treatment with total wrist replacement (TWR). Various prosthetic designs, such as the Universal 2 implant, have been developed in attempts to combat the multitude of complications faced with replacing a complex and highly mobile joint. Having previously published short-term outcome results for the Universal 2 prosthesis, we now present the long-term survival data. Materials and Methods 19 patients underwent 21 TWR using the Universal 2 prosthesis between September 2004 and March 2008. Outcome data were collected in the form of Patient-Rated Wrist Evaluation (PRWE) and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires at short- (mean 4.8 years), intermediate- (mean 11.1 years), and long-term (mean 15.6 years) intervals. Nonparametric and Kaplan–Meier survival analysis was performed. Results At long-term follow-up, 7 out of the original 21 TWRs had required a revision or fusion procedure, or 7 out of 11 when excluding those lost to follow-up or who had died. At the intermediate follow-up, only one patient had required a revision procedure. Kaplan–Meier survival analysis demonstrated a median survival of 12.9 years and a 10-year survival probability of 68.1%. There was a statistically significant improvement from preoperative PRWE at short-term (p = 0.001) and intermediate (p = 0.01) follow-ups. This was not seen at the long-term follow-up (p = 0.068). After an initial improvement in DASH score at short-term follow-up (p = 0.003), the intermediate and long-term DASH scores were not significantly different from preoperative. Conclusion The Universal 2 poses a reasonable TWR implant choice for patients with debilitating arthritis. However, despite excellent short-term follow-up outcomes, longer term follow-up shows the design does continue to be plagued by implant failure and instability.","PeriodicalId":0,"journal":{"name":"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Intermediate and Long-Term Outcomes of the Universal 2 Total Wrist Replacement\",\"authors\":\"Adam Truss, Geraint Morris, Seif Sawalha, Mohammad Waseem\",\"doi\":\"10.1055/s-0043-1772714\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Introduction Arthritis of the wrist can lead to severe functionally debilitating pain which, after failed conservative measures, may require treatment with total wrist replacement (TWR). Various prosthetic designs, such as the Universal 2 implant, have been developed in attempts to combat the multitude of complications faced with replacing a complex and highly mobile joint. Having previously published short-term outcome results for the Universal 2 prosthesis, we now present the long-term survival data. Materials and Methods 19 patients underwent 21 TWR using the Universal 2 prosthesis between September 2004 and March 2008. Outcome data were collected in the form of Patient-Rated Wrist Evaluation (PRWE) and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires at short- (mean 4.8 years), intermediate- (mean 11.1 years), and long-term (mean 15.6 years) intervals. Nonparametric and Kaplan–Meier survival analysis was performed. Results At long-term follow-up, 7 out of the original 21 TWRs had required a revision or fusion procedure, or 7 out of 11 when excluding those lost to follow-up or who had died. At the intermediate follow-up, only one patient had required a revision procedure. Kaplan–Meier survival analysis demonstrated a median survival of 12.9 years and a 10-year survival probability of 68.1%. There was a statistically significant improvement from preoperative PRWE at short-term (p = 0.001) and intermediate (p = 0.01) follow-ups. This was not seen at the long-term follow-up (p = 0.068). After an initial improvement in DASH score at short-term follow-up (p = 0.003), the intermediate and long-term DASH scores were not significantly different from preoperative. Conclusion The Universal 2 poses a reasonable TWR implant choice for patients with debilitating arthritis. However, despite excellent short-term follow-up outcomes, longer term follow-up shows the design does continue to be plagued by implant failure and instability.\",\"PeriodicalId\":0,\"journal\":{\"name\":\"\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0,\"publicationDate\":\"2023-09-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0043-1772714\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0043-1772714","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

摘要

摘要:手腕关节炎可导致严重的功能衰弱性疼痛,在保守措施失败后,可能需要全手腕置换术(TWR)治疗。各种各样的假体设计,如通用2型植入物,已经被开发出来,以对抗更换复杂和高度移动的关节所面临的众多并发症。在之前公布了Universal 2假体的短期结果后,我们现在公布了长期生存数据。材料与方法2004年9月至2008年3月间,19例患者采用Universal 2型假体行21例TWR。结果数据以患者评定腕部评估(PRWE)和手臂、肩膀和手的残疾(DASH)问卷的形式收集,时间间隔为短期(平均4.8年)、中期(平均11.1年)和长期(平均15.6年)。进行非参数和Kaplan-Meier生存分析。结果在长期随访中,原始21例twr中有7例需要翻修或融合手术,排除随访失败或死亡的11例中有7例需要翻修或融合手术。在中期随访中,只有一名患者需要进行翻修手术。Kaplan-Meier生存分析显示中位生存期为12.9年,10年生存率为68.1%。短期随访(p = 0.001)和中期随访(p = 0.01)较术前PRWE有统计学意义的改善。这在长期随访中未见(p = 0.068)。短期随访DASH评分初步改善后(p = 0.003),中期和长期DASH评分与术前比较差异无统计学意义。结论Universal 2为衰弱性关节炎患者提供了合理的TWR种植体选择。然而,尽管短期随访结果良好,但长期随访显示该设计仍然受到种植体失败和不稳定的困扰。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
分享
查看原文
Intermediate and Long-Term Outcomes of the Universal 2 Total Wrist Replacement
Abstract Introduction Arthritis of the wrist can lead to severe functionally debilitating pain which, after failed conservative measures, may require treatment with total wrist replacement (TWR). Various prosthetic designs, such as the Universal 2 implant, have been developed in attempts to combat the multitude of complications faced with replacing a complex and highly mobile joint. Having previously published short-term outcome results for the Universal 2 prosthesis, we now present the long-term survival data. Materials and Methods 19 patients underwent 21 TWR using the Universal 2 prosthesis between September 2004 and March 2008. Outcome data were collected in the form of Patient-Rated Wrist Evaluation (PRWE) and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires at short- (mean 4.8 years), intermediate- (mean 11.1 years), and long-term (mean 15.6 years) intervals. Nonparametric and Kaplan–Meier survival analysis was performed. Results At long-term follow-up, 7 out of the original 21 TWRs had required a revision or fusion procedure, or 7 out of 11 when excluding those lost to follow-up or who had died. At the intermediate follow-up, only one patient had required a revision procedure. Kaplan–Meier survival analysis demonstrated a median survival of 12.9 years and a 10-year survival probability of 68.1%. There was a statistically significant improvement from preoperative PRWE at short-term (p = 0.001) and intermediate (p = 0.01) follow-ups. This was not seen at the long-term follow-up (p = 0.068). After an initial improvement in DASH score at short-term follow-up (p = 0.003), the intermediate and long-term DASH scores were not significantly different from preoperative. Conclusion The Universal 2 poses a reasonable TWR implant choice for patients with debilitating arthritis. However, despite excellent short-term follow-up outcomes, longer term follow-up shows the design does continue to be plagued by implant failure and instability.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信