Radiocarpal fusion and midcarpal resection interposition arthroplasty: long-term results in severely destroyed rheumatoid wrists

Biehl, Christoph; Bräun, Thomas; Thormann, Ulrich; Oda, Amir; Szalay, Gabor; Rehart, Stefan

doi:10.1186/s12891-018-2172-x

Cited by 7 publications

(6 citation statements)

References 33 publications

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“…The levels of cytokines and neuropeptides in the serum and synovial fluid of patients with RA are high, and elevated levels are associated with disease activation 37 – 39 . Furthermore, because the wrist joints are the most common sites of RA lesions 40 , 41 , DRFs can be exposed to high levels of cytokines and neuropeptides that are present in the synovial fluid of the wrists of patients with RA 39 . These cytokines and neuropeptides may induce neurogenic inflammation and vasomotor dysfunction; therefore, RA may be a risk factor for CRPS-1.…”

Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors for Complex Regional Pain Syndrome Type 1 after Surgery for Distal Radius Fractures: A Population-based Study

Jo¹,

Kim²,

Lee

et al. 2019

Sci Rep

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This study aimed to evaluate the incidence rates of and risk factors for complex regional pain syndrome type 1 (CRPS-1) after surgery for distal radius fractures (DRFs). Using data from January 2007 to December 2014, we analysed the data from the Korean Health Insurance Review and Assessment (HIRA) service. After extracting the data of patients aged ≥18 years whose diagnostic and operation codes for DRFs were entered into the HIRA database, we analysed the incidence rates of and risk factors for CRPS-1. From 2007 to 2014, 172,194 DRFs were treated surgically. Within 1 year postoperatively, 1,103 CRPS-1 cases were diagnosed, with an incidence of 0.64%. On univariate and multivariate analyses, the risk factors that significantly correlated with the incidence of CRPS-1 included female sex, rheumatoid arthritis, open reduction, open fracture, and accompanying ulnar fracture, whereas old age, psychiatric disease, and external fixation were not statistically significant. The incidence of CRPS-1 after surgery for DRF was very low (0.64%) in South Korea. Careful monitoring is necessary for patients with complex fractures and rheumatoid arthritis who are at increased risk of developing CRPS-1.

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Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors for Complex Regional Pain Syndrome Type 1 after Surgery for Distal Radius Fractures: A Population-based Study

Jo¹,

Kim²,

Lee

et al. 2019

Sci Rep

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“…One explanation for the significantly worse scores in the DASH score could be the advanced impairment of the wrist joint itself and the adjacent joints. In the study clinic, patients underwent endoprosthetic treatment only at an advanced Larsen stage; earlier stages were reserved for joint-preserving surgery [29]. Pfanner et al describe an average LDE stage of 2-3 for arthroplasty [16].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW®) in Patients with Inflammatory Diseases

Biehl

Stoll²,

Heinrich

et al. 2021

Life

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The wrist is among the predilection sites of over 90% of cases of rheumatoid arthritis (RA). In advanced cases, total wrist arthroplasty (TWA) is an alternative to arthrodesis. The aim of this study is to present the long-term results of the modular physiological wrist prosthesis (MPW®) and to match them in context with the results of a standard population survey. In a retrospective study with follow-up, patients with an MPW® endoprosthesis were evaluated concerning the clinical and radiological outcome, complications were reviewed (incidence and type), and conversion to wrist fusion was assessed. Patient function measurements included the Mayo wrist score, the patient-specific wrist test, and therefore the DASH score (arm, shoulder, and hand). Thirty-four MPW® wrist prostheses were implanted in 32 patients, including thirty primary implantations and four changes of the type of the endoprosthesis. Sixteen patients (18 prostheses) underwent clinical and radiological follow-up. The average follow-up time was 8.5 years (1 to 16). Poor results of the MPW prosthesis are caused by the issues of balancing with luxation and increased PE wear. Salvage procedures included revision of the TWA or fusion. In successful cases, the flexion and extension movement averaged 40 degrees. The grip force was around 2.5 kg. The common DASH score was 79 points, with limited and problematic joints of the upper extremity. The MPW wrist prosthesis offered good pain relief and functional movement in over 80% of cases. The issues of dislocation and increased PE wear prevent better long-term results, as do the joints affected. A follow-up study with fittings under a contemporary anti-rheumatic therapy with biologicals suggests increasing score results. Type of study/level of evidence: Case series, IV.

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“…Adams et al [37] demonstrated that, in young healthy subjects, limited wrist motion inevitably led to a statistically significant worsening of their ratings in activities of daily living (DASH, PRWE), and limited or completely restricted wrist motion with or without pain is subsequently accompanied by impaired power and performance both in elbow and shoulder [6,38]. In patients sustained TWF, the lowest scores found were for perineal hygiene, using a screwdriver, and trouble using the hand in tight spaces such as changing spark plugs on the family car, followed by writing, drinking from a glass, turning a doorknob, combing hair, and using a hammer (i.e.…”

Section: What Is Evident When Wrist Motion Is Impaired?mentioning

confidence: 99%

Functional Outcomes After Salvage Procedures for Wrist Trauma and Arthritis (Four-Corner Fusion, Proximal Row Carpectomy, Total Wrist Arthroplasty, Total Wrist Fusion, Wrist Denervation): A Review of Literature

Schmidt¹

2019

TOORTHJ

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Background: Several salvage procedures for the arthritically destroyed wrist exist. Each of these has advantages as well as disadvantages. Aims: The aim of this article is to give practical insights for the clinician on: (1) biomechanical and clinical fundamentals of normal and impaired wrist motion; (2) difficulties in assessment of postoperative outcome between measured motion by the surgeon and self-reported outcome by the patient; (3) indications for each procedure; and (4) differences in functional outcome between partial and complete motion-preserving as well as complete motion-restricting salvage procedures. Methods: In trend, Proximal Row Carpectomy (PRC) is slightly superior over four-corner fusion (4CF) in terms of functional outcome, but the methodology-related postoperative motion is decreased for both procedures. Furthermore, PRC is easier to perform, needs lower costs, and has fewer complications than 4CF. Total Wrist Arthroplasty (TWA) has the advantage compared to PRC and 4CF that the preoperative motion values are preserved, but it is limited by decreased load-bearing capacity for the wrist. Total Wrist Fusion (TWF) is associated with a higher load-bearing capacity for the wrist than TWA, but it is limited for carrying out essential activities of daily living. Both PRC and 4CF can be combined primarily by wrist denervation. Wrist denervation alone does not impair the movement of the wrist. Results and Conclusion: Salvage procedures for the arthritically destroyed wrist should be detected regarding patients age- and gender-related claims in work and leisure. Not all of them can be successfully re-employed in their original occupations associated with high load-bearing conditions.

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Radiocarpal fusion and midcarpal resection interposition arthroplasty: long-term results in severely destroyed rheumatoid wrists

Cited by 7 publications

References 33 publications

Incidence of and Risk Factors for Complex Regional Pain Syndrome Type 1 after Surgery for Distal Radius Fractures: A Population-based Study

Incidence of and Risk Factors for Complex Regional Pain Syndrome Type 1 after Surgery for Distal Radius Fractures: A Population-based Study

Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW®) in Patients with Inflammatory Diseases

Functional Outcomes After Salvage Procedures for Wrist Trauma and Arthritis (Four-Corner Fusion, Proximal Row Carpectomy, Total Wrist Arthroplasty, Total Wrist Fusion, Wrist Denervation): A Review of Literature

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