Assessing Periprosthetic Bone in Total Wrist Arthroplasty: The Validity of DXA

Holm-Glad, Trygve; Godang, Kristin; Bollerslev, Jens; Røkkum, Magne; Reigstad, Ole

doi:10.1016/j.jocd.2020.10.006

Cited by 2 publications

(4 citation statements)

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“…BMD was obtained in one and three regions of interest (ROIs) around the radial implants (Figure 4), with precision equal to the knee and acetabulum but lower than reported for hip stems. 19 The method was too imprecise to allow for BMD measurement around the carpal and metacarpal implants. 19…”

Section: Methodsmentioning

confidence: 99%

“…19 The method was too imprecise to allow for BMD measurement around the carpal and metacarpal implants. 19…”

Section: Methodsmentioning

confidence: 99%

“…19 the method was too imprecise to allow for bmd measurement around the carpal and metacarpal implants. 19 statistical analysis. revised implants were analyzed in their allocated group regardless of crossover during the study period (intention to treat).…”

Section: Introductionmentioning

confidence: 99%

“…17 Bone mineral density. dXa scans were performed two to four days, and three, six, 12, and 24 months postoperatively using the femoral mode converted to orthopaedic knee mode in the orthopaedic encore v. 16 software (ge healthcare, usa), as described by holm-glad et al 19 The first examination served as baseline. bmd was obtained in one and three regions of interest (rois) around the radial implants (figure 4), with precision equal to the knee and acetabulum but lower than reported for hip stems.…”

Section: Introductionmentioning

confidence: 99%

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A randomized controlled trial comparing two modern total wrist arthroplasties

Holm-Glad

Røkkum

Röhrl

et al. 2022

The Bone & Joint Journal

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Aims To analyze the short-term outcome of two types of total wrist arthroplasty (TWA) in terms of wrist function, migration, and periprosthetic bone behaviour. Methods A total of 40 patients suffering from non-rheumatoid wrist arthritis were enrolled in a randomized controlled trial comparing the ReMotion and Motec TWAs. Patient-rated and functional outcomes, radiological changes, blood metal ion levels, migration measured by model-based radiostereometric analysis (RSA), bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), complications, loosening, and revision rates at two years were compared. Results Patient-Rated Wrist and Hand Evaluation (PRWHE) scores, abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire scores, and pain improved similarly and significantly in both groups. Wrist motion improved significantly in the Motec group only, and forearm rotation in the ReMotion group only. Cobalt (Co) and chromium (Cr) blood ion levels were significantly higher in the metal-on-metal (MoM) Motec group than in the metal-on-polyethylene (MoP) ReMotion group. Mean total translation was 0.65 mm (95% confidence interval (CI) 0.26 to 1.12) and 0.27 mm (95% CI 0.14 to 0.47) for the ReMotion carpal and radial components, and 0.32 mm (95% CI 0.22 to 0.45) and 0.26 mm (95% CI 0.20 to 0.34) for the Motec metacarpal and radial components, respectively. Apart from dorsal and volar tilts, which were significantly higher for the radial ReMotion than for the Motec component, no significant differences in absolute migration occurred. BMD around the radial components never returned to baseline. Almost one-third of patients required reoperation due to complications. Two ReMotion implants were revised to Motec TWAs due to carpal component loosening, and three Motec MoM articulations were revised to metal-on-polyether ether ketone due to painful synovitis. Conclusion Both implants provided matched function and were stable at short-term follow-up, but with a high complication rate. This procedure should be restricted to specialist centres undertaking prospective analysis until its role is clarified. Cite this article: Bone Joint J 2022;104-B(10):1132–1141.

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Section: Methodsmentioning

confidence: 99%

“…19 The method was too imprecise to allow for BMD measurement around the carpal and metacarpal implants. 19…”

Section: Methodsmentioning

confidence: 99%