球窝假体中的斜方杯松动：采用结构髂骨移植物重建斜方，技术和初步结果。

IF 0.9 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2025-04-09 DOI:10.1016/j.hansur.2025.102156

Jean Goubau , Vansh Kapila , Koen Mermuys , Bert Vanmierlo , Chul Ki Goorens , Michiel Cromheecke , Pieter-Bastiaan de Keyzer , Joris Duerinckx

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引用次数: 0

摘要

本研究探讨了球窝假体杯部松动患者应用大量髂骨移植物重建腕关节的结果。7名患者，年龄49-75岁，在2017年11月至2021年1月期间因球窝植入物无菌杯松动接受了翻修手术。手术入路涉及对先前描述的技术的修改，即收获结构性髂骨移植物并将其植入假杯组件以重建斜方体的髓腔。术后评估显示捏紧和握力的改善，而患者报告的结果，包括手臂、肩膀和手的快速残疾（QuickDASH）和视觉模拟量表（VAS）评分，显示疼痛和残疾的显着减少。2例患者需要进一步翻修手术，其中1例技术失败。无急性并发症和感染发生。这些结果表明，髂骨移植重建可能是一种有效的修复方法，可以修复完整的斜方皮质TMC假体的杯型松动，提供良好的功能结果和疼痛缓解。证据水平：iv。

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Trapezial cup loosening in ball and socket prosthesis: Trapezium reconstruction using a structural iliac crest graft, technique and first results

This study investigates the outcomes of trapeziometacarpal joint reconstruction using a massive iliac crest graft in patients with loosening of the cup of a ball-and-socket prosthesis. Seven patients, aged 49–75 years, underwent revision surgery between November 2017 and January 2021 due to aseptic cup loosening of ball-and-socket implants. The surgical approach involved a modification of a previously described technique of harvesting a structural iliac crest graft and implanting it with the prosthetic cup component to reconstruct the medullary cavity of the trapezium. Postoperative assessments showed improvements in pinch and grip strength, while patient-reported outcomes, including Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and Visual Analog Scale (VAS) scores, revealed significant reductions in pain and disability. Two patients required further revision surgery, including one technique failure. No acute complications or infections occurred. These results suggest that iliac crest graft reconstruction may be an effective salvage procedure for cup loosening in TMC prostheses with an intact trapezium cortex, providing favorable functional outcomes and pain relief.

Level of evidence

IV.

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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.