De La Caffinière Thumb Carpometacarpal Replacements

Chakrabarti, A.; Robinson, A. H. N.; Gallagher, P

doi:10.1016/s0266-7681(97)80427-5

Cited by 86 publications

(65 citation statements)

References 11 publications

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“…This kind of prosthesis was followed by the development of several metal total joint implants (ball-andsocket prostheses) which showed good results (17). However, the main problem with these implants was radiographic loosening of the trapezial component (18,19). In more recent years, to avoid this complication, a new material was introduced for TMC implants: pyrolitic carbon.…”

Section: Introductionmentioning

confidence: 99%

Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants

Odella¹

2014

JTS

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Purpose: the aim of this study was to evaluate the effectiveness of interposition arthroplasty of the trapeziometacarpal (TMC) joint with pyrolitic carbon implants for the treatment of TMC osteoarthritis. Methods: we evaluated two groups of patients surgically treated for TMC osteoarthritis: group 1 (34 patients -36 TMC joints) treated with PyroDisk implantation and group 2 (25 patients -25 TMC joints) treated with the Pyrocardan implant. All these patients were clinically evaluated at follow-up using the DASH score, Mayo Wrist score and VAS pain score. Results: the mean follow-up was 42 months in group 1 and 12 months in group 2. Both groups showed good clinical outcomes in terms of pain relief, range of motion, and pinch and grasp strength. Revision surgery was needed in only one case in group 1 (2.8%) and in three cases (12%) in group 2. Conclusions: prosthetic replacement of the TMC joint was found to be a good solution for low-demand patients. However, the PyroDisk could be a good solution in selected patients (Eaton stage I-III, non-subluxated joint): it provides good pain relief, good range of motion, good pinch and grasp strength, and stable results at more than three-years of follow-up. Level of evidence: Level IV, therapeutic case series.

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Section: Introductionmentioning

confidence: 99%

Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants

Odella¹

2014

JTS

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“…20 However, the high complication potential of common CMC I replacement cannot be neglected. [21][22][23] Not all prostheses seem to be suitable to transfer the high mechanical loads of the thumb saddle joint produced during all grasping movements. 24 This results in a large number of clinically reported dislocations.…”

Section: Introductionmentioning

confidence: 99%

Microstructural adaptation in trapezial bone due to subluxation of the thumb

Nufer

Goldhahn

Köhler

et al. 2007

Journal Orthopaedic Research

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Although the thumb saddle is one of the most common sites of degenerative osteoarthritis in the hand, little is known about the altered microstructure in osteoarthritic trapezial bones. External forces resulting from subluxation of the carpometacarpal joint of the thumb (CMC I) should provoke microstructural changes in the trapezium. The purpose of this study was to compare the regional differences of the microstructure between osteoarthritic and healthy trapezial bones. Fifteen trapezia harvested from female patients with radiologically and clinically diagnosed saddle joint osteoarthritis (OA) were compared with 15 unaffected controls. Microstructural parameters, such as bone volume ratio (BV/TV), three-dimensional connectivity (Conn.D), trabecular number (Tb.N), and trabecular thickness (Tb.Th) were studied using a microcomputed tomography (microCT) system. While the trapezial height in OA was 22% less, the sclerotic subchondral bone layer thickness was 50% higher in OA compared with the control group (p < 0.001). In the OA group there was a 42% higher bone volume ratio (p 0.001), an 18% increase in Tb.Th (p ¼ 0.006), and a 10% greater Tb.N (p ¼ 0.034) compared with the control group. Although in both groups BV/TV was significantly lower in the radial region, the radial column showed the highest relative increase in bone volume and structure compared with the control group (þ67% BV/TV, þ20% Tb.Th, þ23% Tb.N). The reinforcement of the bony microstructure in CMC I OA, especially at the radial side, is a sign for bone adaptation reacting to radially shifted joint forces. This has to be considered during the development of new prosthetic alternatives. ß

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“…All planes of movements were reported in only three [2,15,17] studies. Movements such as those recommended by Kapandji [5,9,13,14] were reported in three studies and one article failed to mention movement [4], while eight articles did not mention the preoperative range of movement. Different studies used different instruments and different units to measure grip strength and pinch strength, whereas grip strength was not measured in six studies.…”

Section: Outcome Criteria and Outcome Assessment Methodsmentioning

confidence: 99%

“…Outcome variables like pain were not reported in four studies [3,4,7,13]. Four of the studies used visual analogue scores (VAS) [5,9,14,17] and seven used some form of grading system for the pain. Assessment of functional capabilities was documented in only five studies [9,10,12,14,17].…”

Section: Outcome Criteria and Outcome Assessment Methodsmentioning

confidence: 99%

“…Assessment of functional capabilities was documented in only five studies [9,10,12,14,17]. Patient satisfaction was not documented in 11 studies, good/excellent/fair/poor grading was used in two studies [13,14] and VAS was used in the remaining two studies [5,9]. There was great variability in the reporting of mobility after cemented total-joint arthroplasty of the thumb.…”

Section: Outcome Criteria and Outcome Assessment Methodsmentioning

confidence: 99%

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Analysis of methodological deficiencies of studies reporting surgical outcome following cemented total-joint arthroplasty of trapezio-metacarpal joint of the thumb

Sambandam

Gul

Priyanka

2006

International Orthopaedics (SICO

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Cemented total-joint arthroplasty has been increasingly used in the treatment of end stage arthritis of the thumb trapeziometacarpal joint. Evidence supporting its use in the treatment of trapeziometacarpal disorders in the literature is very limited. Most hand surgeons agree that there are concerns about the methodological quality of the limited literature available. In this study, we analysed the methodological quality of the outcome studies on cemented total-joint arthroplasty of the thumb. We included all the outcome studies published in the English literature on cemented total-joint arthroplasty of the trapeziometacarpal joint of thumb. We analysed these studies for methodological deficiencies and quality of outcome reporting based on the recommendations given by Coleman et al. Our study revealed that there were no uniform standards of outcome reporting. The mean Coleman score for the studies dealing with cemented total-joint arthroplasty of the thumb was 42.9. Major deficiencies were identified in areas like subject selection criteria (0/15), type of study (5.7/15), description of surgical procedure (3.7/5), description of the rehabilitation protocol (2/10), outcome measures (4.4/10) and outcome assessment (3.9/15). The methodological quality of the studies published within the last 10 years (49.9±9.7) was found to be slightly better than the studies published over 10 years ago (39.7±7.8). Our study highlights the need for more evidence in the form of randomised controlled prospective studies conducted with good methodological quality, comparing the cemented total-joint arthroplasty of the thumb to other procedures available for the treatment of disorders of the thumb. Further, to improve the standards of reporting, journal editors should try to standardise the outcome of the reporting by following the surgical procedures on the thumb.Résumé L'usage des prothèses totales cimentées dans le traitement des arthroses sévères trapézométarcarpiennes est en augmentation. Les preuves en faveur de cette utilisation sont rares. La plupart des chirurgiens de la main s'accordent à dire que les études de la littérature ont une méthodologie douteuse. Nous avons analysé dans cette étude la qualité méthodologique de la littérature pour les arthroplasties cimentées. Nous avons inclus pour cette étude tous les résultats publiés dans la littérature anglo-saxonne pour ce type de prothèses. Nous avons étudié les méthodologies et la qualité des résultats selon les recommandations de Coleman et al. Notre étude nous permet de montrer qu'il n'y a pas de standard uniforme pour valider ces résultats. Le score de Coleman et al. dans ces études a été de 42.9 (déviation standard [SD]-9.4). Les problèmes principaux que nous avons identifiés reposent sur les critères de sélection (0/15), le type d'études (5.7/15), la description du traitement chirurgical (3.7/5), la description du protocole de rééducation (2/10), les mesures de surveillance (4.4/10) et le devenir des patients (3.9/15). Pour la qualité méthod-International Orthop...

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De La Caffinière Thumb Carpometacarpal Replacements

Cited by 86 publications

References 11 publications

Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants

Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants

Microstructural adaptation in trapezial bone due to subluxation of the thumb

Analysis of methodological deficiencies of studies reporting surgical outcome following cemented total-joint arthroplasty of trapezio-metacarpal joint of the thumb

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