Patient-rating of long term results of silicone implant arthroplasty of the scaphoid

Vinnars, Bertil; Adamsson, Lennart; Ekenstam, Fredrik af; Wadin, K.; Gerdin, Bengt

doi:10.1080/028443102753478363

Cited by 9 publications

(4 citation statements)

References 23 publications

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“…The treatment reported in the literature for failed partial carpal arthrodesis, carpal silicone implant, first-row resection, or advanced Kienböck disease surgery is usually TWF. [24][25][26][27][28][29] TWF results are not always satisfactory. 30,31 This procedure has complications and the results on pain and function, especially in patients with multiple surgeries are sometimes disappointing.…”

Section: Discussionmentioning

confidence: 99%

“…Kaarela et al observed a 41% rate of this type of complication with lunate implants at 5.6 years follow-up. 37 Vinnars et al had a 62% rate at 10 years follow-up for scaphoid implants 29 and Minami et al had a 33% rate at 15.3 years follow-up with trapezial implants. 38 Wrist arthrodesis is a salvage solution in cases of progressive symptomatic degeneration.…”

Section: Discussionmentioning

confidence: 99%

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Pyrocarbon Interposition Wrist Arthroplasty in the Treatment of Failed Wrist Procedures

et al. 2012

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Treatment of failures after prior wrist surgeries with major articular destruction is challenging. In most cases, total wrist fusion is the only possible salvage procedure. We propose a new interposition arthroplasty with a pyrocarbon implant called Amandys. A total of 16 patients, 14 men and 2 women, with a mean age of 56 years were operated on for a failure of wrist surgery performed previously, with an average time lapse of 12 years. The prior surgeries were partial wrist arthrodesis in seven cases, silicone implant interpositions in five cases, advanced Kienb?ck disease (Lichtman IV) treatment in two cases, proximal row carpectomy in one case, and an isolated scaphoidectomy in one case. A prospective study with clinical and radiological evaluation was performed with a mean follow-up of 24 months (6 to 41 months). Pain and function showed significant improvement. The mean pain score decreased from 7 of 10 to 4 of 10, postoperatively. The mean grip strength was 19?kg (53% of the contralateral side), and the mean range of motion in flexion extension was 68 degrees. Mean strength and range of motion did not change significantly with the operation. The mean QuickDASH (Disability Arm Shoulder and Hand) score decreased from 59 of 100 to 39 of 100. The mean Patient-Rated Wrist Evaluation decreased from 57 of 100 to 33. Two patients (12.5%) required revision for implant repositioning. No dislocation or subsidence of the implant was noted. Pyrocarbon interposition arthroplasty is a new option for treatment of advanced wrist destruction. Preliminary short-term results suggest that it may be a reliable alternative to total wrist fusion. The level of evidence of this study is IV (therapeutic case series).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pyrocarbon Interposition Wrist Arthroplasty in the Treatment of Failed Wrist Procedures

et al. 2012

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“…Silicone prosthesis for the proximal pole was proposed by Swanson. The long-term results 20,28 are satisfactory in terms of pain control and function; however, the rate of revision surgery for secondary dislocation of the implant is relatively large, in addition to a high rate of cystic bone changes secondary to a synovitis caused by the silicone implant. 29 Furthermore, this implant does not prevent the evolution of osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…A simple resection of the proximal pole of the scaphoid could be performed, but there is a concern regarding the stability of the carpus. 20 Many different surgical reconstructive options for SNAC wrist have been reported. Several papers have reported using a synthetic replacement such as silicone, Vitallium, 21 acrylic 22,23 and titanium, 24 glutaraldehyde and bovine fibrocartilage, 25 and collagen and bone morphogenetic protein (BMP).…”

Section: Surgical Treatment Options For Scaphoid Nonunionmentioning

confidence: 99%

Treatment of Avascular Necrosis of the Proximal Pole of the Scaphoid by Arthroscopic Resection and Prosthetic Semireplacement Arthroplasty Using the Pyrocarbon Adaptive Proximal Scaphoid Implant (APSI): Long-Term Functional Outcomes

Gras¹,

Wahegaonkar

Mathoulin

2012

Jnl Wrist Surg

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Fractures of the proximal pole of the scaphoid with associated avascular necrosis and nonunion are well known to be problematic. Many techniques for fixation and reconstruction of the proximal pole of the scaphoid have been reported, often with poor results. One of the newer modalities of treatment for these difficult cases is excision of the proximal pole and replacement with a pyrocarbon implant. The ovoid shape of the implant acts as a spacer and repositions itself throughout the range of motion of the wrist. The procedure can be performed arthroscopically, thus reducing the morbidity and allowing the procedure to be a day case. Satisfactory results have been reported in elderly patients, but there is a paucity of literature regarding the outcomes in younger patients. This multicenter retrospective study evaluates the clinical, radiologic, and functional outcomes in patients under the age of 65 years with a minimum follow up of 5 years. There were 14 patients with scaphoid nonunion advanced collapse (SNAC) grade I, II, or III wrists, with a mean age of 53 years and mean follow up of 8.7 years. There were improvements in all of the patient related variables including VAS pain scores (7.5 to 0.7), extension (45°to 60°), flexion (32°to 53°), and grip strength (15.8 to 34.6 kg). Complications included volar subluxation of the implant, which was acutely surgically corrected (1), volar subluxation of the implant, with persistent pain that required a four-corner fusion (2), and secondary radial styloidectomy (3). This technique is an attractive, minimally invasive alternative for nonunion and avascular necrosis resulting from fractures of the proximal pole of the scaphoid. The authors provide details of the technique, including technical suggestions for performing the procedure.

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Custom Total Joint Arthroplasty

Marcellin‐Little

Harrysson

2012

Advances in Small Animal Total Joint Replacement

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Patient-rating of long term results of silicone implant arthroplasty of the scaphoid

Cited by 9 publications

References 23 publications

Pyrocarbon Interposition Wrist Arthroplasty in the Treatment of Failed Wrist Procedures

Pyrocarbon Interposition Wrist Arthroplasty in the Treatment of Failed Wrist Procedures

Treatment of Avascular Necrosis of the Proximal Pole of the Scaphoid by Arthroscopic Resection and Prosthetic Semireplacement Arthroplasty Using the Pyrocarbon Adaptive Proximal Scaphoid Implant (APSI): Long-Term Functional Outcomes

Custom Total Joint Arthroplasty

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