Touch®梯形跖骨假体治疗根治性关节炎的有效性：5年回顾性研究

IF 0.9 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2024-12-01 DOI:10.1016/j.hansur.2024.101821

Leila Essid, Elise Boudousq, David Guillier, Narcisse Zwetyenga, Alain Tchurukdichian

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引用次数: 0

摘要

斜跖骨关节炎或根状关节病，是一种常见的拇指基部骨性关节病。全关节置换术是一种有趣的治疗方法。双活动的Touch®假体已经面世好几年了，只有少数研究发表来评估这种假体的长期安全性和有效性。本研究的目的是描述触觉假体至少5年随访的结果。2016年3月至2018年7月期间在两个研究中心接受Touch假体的患者，并进行了5年的随访，纳入了这项回顾性和非比较性研究。从筛选的111例患者中，纳入74例患者，其中8例双侧手术。手术时平均年龄为62.4（±7.3）岁。其中女性62例（83.8%），51.2%为优势手。5年随访，疼痛（VAS）、握力和键捏明显改善。快速DASH从55.1降至14.6。Kapandji对位和后退后，MCP主动活动屈伸得到改善。91.3%的患者满意。轻微不良事件19例（23.2%），严重不良事件8例（9.8%）。最常见的不良事件是暂时性感觉不良，占8.6%。5个假体（6.1%）被修复，1个假体（1.2%）被移除，导致所有类型事件的5年种植体调查率为92.7%。然而，如果只计算设备或手术相关事件，生存率为97.6%。在82例假体的5年中，92.7%的假体仍然放置，4.9%的假体发生了部件变化，只有2.4%的假体转为梯形切除术。结果显示中期临床获益持续，患者满意度较高。他们恢复并保持了一个强大的拇指。19例（23.2%）与器械操作相关的不良事件无需或轻微处理，均可轻松解决。与器械或手术相关的5个主要并发症（6.1%）也无困难地得到解决。在6例假体故障中，只有2例是由该装置引起的。双活动假体是治疗中期CMC关节骨关节病的可靠方法。

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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Efficacité de la prothèse trapézo-métacarpienne Touch® dans le traitement de la rhizarthrose : étude rétrospective à 5 ans

Trapezometacarpal Osteoarthritis or rhizarthrosis, is a frequent osteoarthrosis of the base of the thumb. The total joint replacement represents an interesting surgical option for its treatment. The double-mobility Touch® prosthesis is available for several years and only few studies have been published to evaluate the safety and efficiency of this prosthesis in the long term. The objective of this study is to describe the outcomes of the Touch prosthesis for a minimal 5 years follow-up.

Patients who received a Touch prosthesis in the two investigational centers between March 2016 and July 2018, and with a 5 years follow up, were included in this retrospective and non-comparative study.

From 111 patients screened, 74 patients were included of which 8 had surgery at both sides. The mean age at the time of surgery was 62.4 (± 7.3) years. 62 (83.8%) were women and 51.2% of the patients had their dominant hand operated. The pain (VAS), Grip and Key pinch were significantly improved at five years follow-up. The quick DASH decreased from 55.1 to 14.6. The Kapandji opposition and retropulsion, the MCP active mobility flexion and extension improved. 91.3% of the patients are satisfied. 19 (23.2%) adverse events were minor and 8 (9.8%) were major. The most common adverse event was temporary dysesthesia representing 8.6%. 5 (6.1%) prostheses were revised and 1 (1.2%) was removed which lead to an implant survey of 92.7% at 5 years for all type of events. However, the survival rate is 97.6% if only device or procedure related events are counted. At five years of the 82 prosthesis, 92.7% are still placed, 4.9% had a component change and only 2.4% were converted to trapeziectomy.

The results show a persistence of clinical benefit at middle term with high satisfaction of patients. They regained and kept a strength thumb. 19 (23.2%) adverse events linked to the device procedure needed none or minor treatment and could all be resolved easily. The 5 (6.1%) major complications linked to the device or procedure were also resolved without difficulties. Of the six prostheses failure, only two were due to the device.

The double-mobility prosthesis is a reliable treatment of the CMC joint osteoarthrosis at middle term.

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.