Results from a degradable TMC joint Spacer (Artelon) compared with tendon arthroplasty

Nilsson, Anders; Liljensten, Elisabeth; Bergström, Christina; Sollerman, Christer

doi:10.1016/j.jhsa.2004.12.001

Cited by 112 publications

(121 citation statements)

References 33 publications

(23 reference statements)

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“…Four patients underwent revision surgery. This rate is substantially higher than previously reported [8][9][10][11]. We could not identify any factors that were significantly associated with the revision rate.…”

Section: Discussioncontrasting

confidence: 80%

“…The Artelon spacer is a T-shaped device made of a degradable polycaprolactone-based polyurethaneurea that was developed for use in thumb CMC arthritis to resurface the distal aspect of the trapezium and to stabilize the trapeziometacarpal joint by augmentation of the joint capsule [8][9][10][11]. The device is meant as a biological spacer to prevent bony impingement while providing a scaffold for tissue ingrowth to occur as resorption of the device occurs.…”

Section: Introductionmentioning

confidence: 99%

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Complications with the Use of Artelon in Thumb CMC Joint Arthritis

Clarke

Hagberg

Kaufmann

et al. 2011

Hand (New York, N,Y.)

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Background Complications with the use of the Artelon spacer in thumb carpometacarpal (CMC) joint arthritis include inflammation, osteolysis, and persistent pain. We evaluated our short-term results and complications. Methods A retrospective review of 29 patients was performed. Pre-and postoperative radiographs, operative techniques, complications, and subsequent surgeries were analyzed. Pearson's and chi-squared testing was used to identify associations between complications and surgical technique or preoperative radiographic criteria. The average age was age 51±7.7 (34-66), average follow-up was 8 months (1-26). Results Twelve patients sustained complications. Nine patients displayed postoperative osteolysis. Four patients underwent conversion to CMC suspensionplasty due to persistent pain. The rate of revision surgery and radiographic postoperative osteolysis were not significantly associated with preoperative arthritis grade, metacarpal subluxation, or surgical techniques: fixation method, the bony surface(s) involved in the osteotomy, or spacer modifications. Conclusions Our study found a significant short-term complication rate following Artelon spacer arthroplasty of the CMC joint. This is higher than previously described.We could not identify any factors that were significantly associated with the complications. It is possible that the inherent instability of the joint or the material of the spacer is involved in implant failure. Further study is necessary to better define the indications for use and specific techniques for the use of the implant.

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Section: Discussioncontrasting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Complications with the Use of Artelon in Thumb CMC Joint Arthritis

Clarke

Hagberg

Kaufmann

et al. 2011

Hand (New York, N,Y.)

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“…A common theme in studies in which a Kirschner wire was used after the surgical procedure [3,6,14,15] was that patients were casted or splinted at least until the wire was removed, which occurred 4 to 5 weeks after surgery. For the studies in which some sort of joint prosthesis was implanted [1,9,18,20,21,24], postoperative immobilization time ranged from 2 to 6 weeks. The type of immobilization used for the studies was described in varying detail.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Postoperative Hand Therapy Management of Basal Joint Arthritis

Wolfe

Chu

Woods

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background There are a variety of postoperative immobilization and therapy options for patients with basal joint arthritis. Although prior systematic reviews have compared surgical procedures used to treat basal joint arthritis, none to our knowledge compares therapy protocols for this condition, which are considered an important part of the treatment.Questions/purposes (1) We sought to determine whether differences in the length and type of postoperative immobilization affect clinical results after basal joint arthritis surgery. (2) We also compared specific therapy protocols that were prescribed. (3) Finally, we evaluated published protocols to determine when patients were released to full activity to see whether these appeared to affect clinical results. Methods A systematic review of English-language studies in the PubMed and Cochrane databases was performed. Studies were then reviewed to determine what postoperative immobilization and therapy protocols the authors used and when patients were released to full activities. A total of 19 studies were identified using the search criteria.

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“…The manuscripts that formed the major portion of the review (n = 22) include those focused on arthroscopic débridement or partial trapeziectomy with case series and adequate outcomes data (n = 11) [2,9,14,15,17,18,21,25,27,28,34]; open series that provided information regarding the interposition material or changes in the STT joint or MCP hyperextension (n = 7) [8,10,23,[31][32][33]39]; and review or techniques articles or a case study with some limited original clinical data (n = 4) [4,5,12,41].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…Two manuscripts were case series or reports documenting inflammatory response and unsatisfactory results in terms of pain relief [8,37] resulting in revision surgery and explantation. Others [23,31,32] documented comparison studies between the Artelon 1 spacer and tendon arthroplasty. Patients with the Artelon 1 implant had a higher rate of swelling and revision surgery in two series, generally as an explantation and conversion to arthroplasty (six of 72 [32] and two of 13 [23]).…”

Section: Manufactured Materialsmentioning

confidence: 99%

Does Arthroscopic Débridement With or Without Interposition Material Address Carpometacarpal Arthritis?

Adams

2014

Clinical Orthopaedics &Amp; Related Research

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Background Thumb carpometacarpal (CMC) joint arthritis is a common problem in clinical practice with a variety of treatment options. Arthroscopic procedures can preserve all or part of the trapezium in the setting of treatment of basilar joint arthritis, and such procedures (even without stabilization or ligament reconstruction) have high reported success rates. However, little is documented about the limitations of these procedures in terms of patient selection, the optimal type of interposition, if any, and rehabilitation. Questions/purposes A systematic review was performed to determine the influence of (1) interposition material (manufactured, biological, or none); and (2) patient-related factors (including metacarpophalangeal joint hyperextension, ligamentous laxity, and severity of arthritis) on pain, functional scores, and postoperative complications unique to each approach.Methods A systematic review of the English language literature regarding thumb basilar joint arthritis and arthroscopic partial trapeziectomy or débridement was performed. Those procedures including ligament reconstruction or stabilization were excluded. Results Biological materials and no interposition were both associated with satisfactory improvement and low rates of complications; complication rates with synthetic materials were higher. Eaton Stages I to III were treated successfully with this technique. The effect of scaphotrapeziotrapezoid (STT) changes was variably described across series. In most series, metacarpophalangeal hyperextension did not seem to have an adverse effect on outcomes, although these patients were excluded in some series. Conclusions Arthroscopic débridement with or without interposition can be used for treatment of Eaton Stages I to III CMC osteoarthritis with satisfactory outcomes. Some series suggest satisfactory outcomes in the setting of STT changes and metacarpophalangeal hyperextension.

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Results from a degradable TMC joint Spacer (Artelon) compared with tendon arthroplasty

Cited by 112 publications

References 33 publications

Complications with the Use of Artelon in Thumb CMC Joint Arthritis

Complications with the Use of Artelon in Thumb CMC Joint Arthritis

A Systematic Review of Postoperative Hand Therapy Management of Basal Joint Arthritis

Does Arthroscopic Débridement With or Without Interposition Material Address Carpometacarpal Arthritis?

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