Arthroplasty in the hand: what works and what doesn’t?

Herren, Daniel; Ishikawa, Hajime; Rizzo, Marco; Ross, Mark; Solomons, Michael

doi:10.1177/17531934211017703

Cited by 7 publications

(6 citation statements)

References 49 publications

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“…All patients needing revision presented with a dislocation of the implant, which in our opinion may be related to the instability inherently related to Pyrocardan®. In a series by Herren et al [ 21 ], authors reported a less favourable outcome after revision surgery as compared to primary trapeziectomy. Conversely, it should be emphasized that in our series, patients who undergone trapeziectomy reported clinical results overlapping those reported after primary trapeziectomy (18.3 points for DASH as compared to 17–34 points reported in a recent systematic review about trapeziectomy [ 22 ]).…”

Section: Discussionmentioning

confidence: 99%

Pyrocardan® interpositional arthroplasty for trapeziometacarpal osteoarthritis: a minimum four year follow-up

Smeraglia

Basso

Famiglietti

et al. 2022

International Orthopaedics (SICOT)

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Background Pyrocardan® (Wright Medical-Tornier) is a pyrocarbon implant proposed in the treatment of trapeziometacarpal joint (TMCJ) osteoarthritis. Our aim was to assess the clinical and radiographic results after Pyrocardan® arthroplasty at midterm follow-up. Methods In this prospective monocentric study, we enrolled 119 patients treated with Pyrocardan® for TMCJ osteoarthritis and followed up at a minimum of four years. The clinical outcome was assessed through the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Visual Analog Score (VAS) for pain and the Kapandji score collected pre-operatively, at three, six and 12 months, then yearly. Hand radiographs were taken before surgery, at three months and every year. Complications and re-operations were also recorded. Results The mean follow-up was 5.2 years (range, 4–9). DASH, VAS and Kapandji scores significantly improved at three (p < 0.001 in all cases) and six months (p < 0.001, p = 0.01 and p < 0.001, respectively), remaining stable over time. The dislocation and subluxation rates were 3.3% (4 cases) and 16.8% (20 patients), respectively. The two year, four year and seven year survivorship of the implant was 99%, 98% and 95%, respectively. Conclusion Pyrocardan® arthroplasty provides a satisfactory clinical and radiographic outcome for treating TMCJ osteoarthritis, with a 97% survival rate at four years. We advocate comparative studies with more common techniques (i.e., trapeziectomy) to verify its cost-effectiveness.

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Section: Discussionmentioning

confidence: 99%

Pyrocardan® interpositional arthroplasty for trapeziometacarpal osteoarthritis: a minimum four year follow-up

Smeraglia

Basso

Famiglietti

et al. 2022

International Orthopaedics (SICOT)

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“…The capsule and sagittal band is repaired, and the extensor tendon is centralized if needed to prevent recurrent deformity. 3 Intrinsic release or transfer will help restore alignment and correct potential distal swan neck deformity.…”

Section: Surgical Approachmentioning

confidence: 99%

“…22 Additional studies found no difference in range of motion or complications between the dorsal and volar approaches. 3,23,24…”

Section: Surgical Approachmentioning

confidence: 99%

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Small Joint Arthroplasty of the Hand: An Update on Indications, Outcomes, and Complications

Strother

Moran

Rizzo

2023

J Am Acad Orthop Surg

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Small joint arthroplasty of the hand is a well-established surgery that can preserve motion and provide reliable pain relief, joint preservation, and improvement in hand function. Soft-tissue integrity is critical in patient and implant selection to avoid postoperative joint instability. Although instability is more common in nonconstrained implants such as pyrocarbon, silicone arthroplasty is associated with high rates of late implant fracture and failure with resultant recurrent deformity and instability. Additional complications such as stiffness, extension lag, and intraoperative fractures may be mitigated by alterations in surgical technique and postoperative rehabilitation protocols. Revision arthroplasty with soft-tissue stabilization procedures have reliable outcomes and can avoid conversion to arthrodesis. This article will review the surgical indications, outcomes of small joint arthroplasty in the hand, and common complications and their management.

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“…Arthroplasty of the hand, which involves the surgical removal and replacement of damaged cartilaginous surfaces in the joint, often emerges in many patients as the sole option for improving mobility and alleviating pain [214]. Typically requiring the use of an implant [215], this intervention particularly concerns the proxi-8. Towards a disruptive, minimally invasive small finger joint implant concept:…”

Section: Introductionmentioning

confidence: 99%

To fix or not to fix!? Strategies and tools to place and fixate a flexible joint implant

Farjam

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Osteoarthritis (OA) is a prevalent type of degenerative arthritis resulting from cartilage wear and tear, predominantly affecting joints like the knee, hand, and hip. Specifically, hand OA often impacts multiple hand joints, leading to significant patient loss of function and discomfort and substantial costs related to diagnostics, treatment, and productivity losses.When conservative treatments fail to alleviate pain and functional issues in hand OA, surgical intervention becomes necessary. Numerous arthroplasty implants exist for various finger joints, but often complications occur, like implant loosening and dislocation. Despite advancements in joint prosthetic design, the overall outcome has shown minimal improvement over time.The APRICOT® (Anatomically Precise Revolutionary Implant for bone Conserving Osteoarthritis Treatment) patented by Aurora Medical Ltd (Chichester, UK) represents a groundbreaking solution to address the challenges posed by existing finger joint implants for osteoarthritis. This innovative implant is specifically tailored for small joints affected by osteoarthritis, offering a self-lubricated polymeric sac that mimics the natural joint's low-friction characteristics. Unlike conventional implants, APRICOT® facilitates full joint range of motion through its unique caterpillar-like internal motion, supported by an internal lubricant coating that minimizes friction. Currently in its proof-of-concept phase, the APRICOT® project aims to overcome significant challenges associated with osteoarthritis treatment in small joints. Key objectives of this thesis include identifying a required anchoring system for secure implant fixation, establishing an effective implantation strategy, and designing and testing specialized surgical instruments to facilitate the implantation process.

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Arthroplasty in the hand: what works and what doesn’t?

Cited by 7 publications

References 49 publications

Pyrocardan® interpositional arthroplasty for trapeziometacarpal osteoarthritis: a minimum four year follow-up

Pyrocardan® interpositional arthroplasty for trapeziometacarpal osteoarthritis: a minimum four year follow-up

Small Joint Arthroplasty of the Hand: An Update on Indications, Outcomes, and Complications

To fix or not to fix!? Strategies and tools to place and fixate a flexible joint implant

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