Universal 2 全腕关节置换术的长期疗效

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2024-10-09 DOI:10.1016/j.jor.2024.10.004

Alexander Tham, Andrew Ross, Jonathan Wright, David J. Martin, Marc Bransby-Zachary, Duncan J. MacDonald, John W. Kennedy

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引用次数: 0

摘要

目的 Universal 2 全腕关节置换术（TWA）旨在减轻腕部疼痛并恢复功能。本研究调查了 Universal 2 TWA 的存活时间、翻修率、并发症发生率，并对其进行了长期放射学分析。结果平均随访时间为 11.7 年（2.5-17.6 年）。术后 DASH 评分（平均 58.3 分，标准差 13 分）与术前 DASH 评分（平均 33 分，标准差 20 分，P < 0.001）相比有明显改善。在最近一次随访中，65%的患者将接受手术，比中期随访时的87%有所下降。在放射学分析中，有26只手腕至少有一个组件出现裂隙。18只手腕（38%）出现并发症。有 11 个 TWA（23%）在术后平均 7.3 年（2.0-13.7 年）进行了修复。植入物的平均存活时间为 13.6 年（12.2-15.0 年，95% CI）。Kaplan-Meier 分析表明，炎性关节炎（13.2 年，11.5-14.9 年，95 % CI）和骨关节炎（12.9 年，11.0-14.8 年，95 % CI，p = 0.39）之间的存活率无明显差异。结论：在长期随访中，Universal 2 TWA 可以明显改善 DASH 评分，满意度也很高。然而，相当多的植入体出现了放射性松动，相关并发症和翻修率也很高。患者在术前应充分了解这些风险。

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Long-term outcomes of the Universal 2 total wrist arthroplasty

Aims

The Universal 2 total wrist arthroplasty (TWA) aims to alleviate wrist pain and restore function. This study investigates the survival time, revision rate, complication rate, and performs radiological analysis on Universal 2 TWAs in the long term.

Methods

Forty-seven Universal 2 TWA in 45 patients were performed between 2006 and 2014. Patient satisfaction, DASH score, complications, revision rate and radiological analysis of the TWA were recorded.

Results

Mean follow-up was 11.7 years (range 2.5–17.6 years). There was significant improvement in post-operative DASH score (mean 58.3, SD 13) compared to preoperative DASH scores (mean 33, SD 20, p < 0.001). At latest follow-up, 65 % of patients would undergo the procedure, a reduction from 87 % at mid-term follow-up. On radiological analysis, 26 wrists had lucencies of at least one component. Complications occurred in 18 wrists (38 %). Eleven TWA (23 %) were revised at a mean 7.3 years post-operation (range 2.0–13.7 years). Mean survival of the implant was 13.6 years (12.2–15.0 years 95 % CI). Kaplan-Meier analysis identified no significant differences in survivorship between inflammatory arthritis (13.2 years, 11.5–14.9 years 95 % CI) and osteoarthritis (12.9 years, 11.0–14.8 years 95 % CI, p = 0.39).

Conclusion

At long-term follow-up, the Universal 2 TWA can produce significant improvements in DASH scores and good satisfaction rates. However, a significant number of implants showed radiological loosening, with a high associated complication and revision rate. Patients should be adequately counselled on these risks pre-operatively.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.