More than 40 years’ follow-up of an unconstrained metal lunate replacement for the treatment of Kienböck’s disease

Parwaiz, Hammad; Elnikety, S

doi:10.1136/bcr-2017-223546

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Nowadays, titanium and its alloys are the relatively mature bone filling materials in clinical application, but studies have found that long-term complications such as loosening and stress shielding of the prosthesis are prone to occur in the long-term follow-up after titanium prosthesis implantation ( Parwaiz and Elnikety, 2018 ). In addition, the osseointegration ability and antibacterial properties of titanium alloy materials are still far from achieving the expected effects clinically.…”

Section: Discussionmentioning

confidence: 99%

“…Many prosthetic materials have been applied in scaphoid and lunate replacement, such as silicone rubber, cobalt chromium molybdenum alloy, acrylic, cobalt chromium, and titanium; however, these materials may lead to synovitis, arthritis, stress shielding, and other complications. Finding the most suitable prosthetic material has always been a challenge for us ( Lippman and McDermott, 1949 ; Agerholm and Goodfellow, 1963 ; Barber and Goodfellow, 1974 ; Marcuzzi et al, 2011 ; Parwaiz and Elnikety, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

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Carpal bone replacement using personalized 3D printed tantalum prosthesis

Zhang,

Chen,

Fan

et al. 2023

Front. Bioeng. Biotechnol.

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Objective: Scaphoid and lunate fractures have a relatively high incidence rate. Traditional carpectomy and carpal arthrodesis in the treatment of carpal osteonecrosis will lead to many complications. Three-dimensional (3D) printed tantalum has good biocompatibility and can be designed to match the patient’s personalized anatomical carpal structure. This study aims to investigate carpal function and prosthesis-related conditions after carpal bone replacement using 3D printed tantalum prostheses.Methods: From July 2020 to January 2022 at our center, seven patients with osteonecrosis of the carpus received carpal bone replacement using 3D printed tantalum prosthesis. The Disability of the Arm, Shoulder and Hand (DASH) score and patient satisfaction, as well as the Mayo Wrist Scores (Cooney method, modified Green, and O’Brien wrist score), were used to evaluate the preoperative and postoperative wrist function of patients. The Visual Analog Scale (VAS) pain scores were also recorded before and after surgery. The angles of flexion, dorsiflexion, ulnar deviation, and radial deviation were measured using an arthrometer. The grip strength and pinch strength of the operated hand after carpal bone replacement and the contralateral healthy carpus were measured using a dynamometer. Radiographs were taken to confirm the condition and complications of the tantalum prosthesis.Results: All seven patients were followed for 19.6 ± 2.7 months. At the last follow-up, the grip strength of the operated wrist joint after carpal bone replacement was 33.4 ± 2.3 kg, the pinch strength was 8.9 ± 0.7 kg, the flexion was 54.6° ± 0.8°, the dorsiflexion was 54.7° ± 1.7°, the ulnar deviation was 34.6° ± 1.9°, and the radial deviation was 25.9° ± 0.8°, all of which showed no statistically significant difference with the contralateral healthy carpus (p > 0.05). There were significant differences in the VAS, DASH, and MAYO scores between the preoperative and the last follow-up (p < 0.01). Patients had reduced postoperative pain and improved wrist function and range of motion (ROM), and the tantalum prostheses were stable.Conclusion: The 3D printed tantalum brings us new hope, not only for hip or knee replacement, but also for joint replacement of other complex anatomical structures, and patients with other irregular bone defects such as bone tumors and deformity, which could realize personalized treatment and precise medicine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Carpal bone replacement using personalized 3D printed tantalum prosthesis

Zhang,

Chen,

Fan

et al. 2023

Front. Bioeng. Biotechnol.

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Pyrocarbon Lunate Replacements Perform Well at Two Years: A Retrospective Case Series and Technique from Two UK Tertiary Centres

Alao

Bodansky

Hajipour

et al. 2022

J Hand Surg Asian-Pac Vol

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Background: We report medium-term results in our case series of patients with Kienböck disease receiving a pyrocarbon lunate replacement (Integra, Smith and Nephew, Watford, UK). Methods: Patients with Kienböck receiving a pyrocarbon lunate between September 2012 and November 2020, with stage 3b and above were included. Patients were staged preoperatively with radiographs and MRIs. Pre- and postoperative visual analogue scores and movement were documented. Postoperative radiographs were obtained at 6 weeks, 6 months and 1 year. Results: Seven patients were identified, all female, with a median age of 28.0 years. All but one had 3b disease and the median follow-up was 2 years (range 13–112 months). A mean 9/10 preoperative VAS score improved to 1/10 by 3 months postoperatively (p < 0.001, paired t-test). No major complications were seen, and implants were stable radiologically. Conclusions: A semi-constrained pyrocarbon lunate can provide good results for patients with advanced Kienböck’s disease, offering an alternative to proximal row carpectomy salvage surgery. Level of Evidence: Level IV (Therapeutic)

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More than 40 years’ follow-up of an unconstrained metal lunate replacement for the treatment of Kienböck’s disease

Cited by 2 publications

References 12 publications

Carpal bone replacement using personalized 3D printed tantalum prosthesis

Carpal bone replacement using personalized 3D printed tantalum prosthesis

Pyrocarbon Lunate Replacements Perform Well at Two Years: A Retrospective Case Series and Technique from Two UK Tertiary Centres

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