Salvage of the Failed Total Wrist Arthroplasty: A Systematic Review

Berber, Onur; Gidwani, Sam; Garagnani, Lorenzo; Spiteri, Michelle; Riley, Nicholas; McNab, Ian; Little, Christopher

doi:10.1055/s-0040-1713728

Cited by 24 publications

(58 citation statements)

References 22 publications

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“…The rate of 12% of revision in our study remained lower than some rates reported for TWF and TWA. [31][32][33] Herzberg et al 34 reported, in his series of TWA using ReMotion 6% of revision.…”

Section: Discussionmentioning

confidence: 98%

“…These secondary procedures did not affect the final results and no significant difference in final outcomes was found between the patients requiring surgical revision and the other patients (►Table 7). Berber et al, 33 in a systematic review of 214 revision procedures for TWA failure, found a temporary improvement in functional scores at 1 year, which deteriorated at 5 years with a high rate of rerevision regardless of the type of revision (21% after TWF and 35% after TWA).…”

Section: Discussionmentioning

confidence: 99%

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Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases

et al. 2021

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Background Amandys is a pyrocarbon interposition implant used as a therapeutic alternative to total wrist fusion (TWF) or total wrist arthroplasty (TWA) in painful and disabling extensive destruction of the wrist. Objective To review mid-term outcomes in a continuous prospective series of patients who underwent wrist arthroplasty Amandys with a minimum follow-up of 5 years. Methods Clinical evaluation included a satisfaction survey, pain, two functional scores, the short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the Patient-Rated Wrist Evaluation (PRWE), active wrist mobility, and grip strength compared with the contralateral side. Radiological evaluation was used to detect implant subsidence, carpal migration, bone lysis, or implant malposition. All per- and postoperative complications were collected. Results Fifty-nine patients (63 procedures) were evaluated with a mean follow-up of 7 years; 57% of the patients were males, and the mean age was 58 years. Among the patients, 90% were satisfied or very satisfied. Pain was significantly improved, with a gain of 4/10 (p < 0.001). Functional outcomes also improved between the second and fifth year of follow-up. Active mobility was preserved and grip strength was significantly improved by 7 kg (p < 0.001). No implant subsidence or carpal migration was observed. Ten patients (11.9%) underwent revision surgery for conflict (1%), rotation (6%), or implant dislocation (5%). All complications and revisions occurred early with no new events after 1 year of follow-up. Discussion Mid-term clinical and radiological outcomes were stable with improvement of functional scores. The survival rate was comparable to that reported for TWF with conserved mobility. We report fewer complications compared with those reported for TWA or TWF. Early instability of the implant was the main etiology of the revisions. Repositioning of the implant was successful. No conversion to TWA or TWF was necessary. Conclusions Mid-term outcomes of the Amandys implants were encouraging. Patients conserved good wrist motion with improved strength and functional scores. The implant was well tolerated. Functional outcomes continue to improve with the follow-up. The survival rate remains stable after 2 years. The level of evidence of this study is IV (therapeutic case series).

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases

et al. 2021

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“…► artrodesis de muñeca ► fusión de muñeca ► placa ► tasa de consolidación ► complicaciones recent systematic review (2018) found a complication rate of 6.1% for total wrist arthrodesis. 14 In this context, a low profile and variable angle locked plate (TriLock APTUS 2.5 wrist arthrodesis plate, Medartis AG, Basel, Switzerland) was developed for total wrist arthrodesis. It has rounded edges and an anatomically curved "low profile" minimizing the potential for soft tissue irritation or tendon friction.…”

Section: Palabras Clavementioning

confidence: 99%

“…11-13 Una revisión sistemática más reciente (2018) encontró una tasa de complicaciones del 6,1% para la artrodesis total de muñeca. 14 En este contexto, se desarrolló una placa bloqueada de bajo perfil y ángulo variable (placa de artrodesis de muñeca TriLock APTUS 2.5, Medartis AG, Basilea, Suiza) para la artrodesis total de muñeca. Tiene bordes redondeados y un "perfil bajo" anatómicamente curvado que minimiza la posibilidad de irritación de los tejidos blandos o fricción de los tendones.…”

Section: Introductionunclassified

Artrodesis Total de la Muñeca con Placa Dorsal Bloqueada de Bajo Perfil y Ángulo Variable: Tasa de Consolidación y Complicaciones de 85 casos Consecutivos

Vasquez,

Siestrup,

Guedes

et al. 2023

Revista Iberoamericana de Cirugía de la Mano

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Resumen Introducción La artrodesis de muñeca ha evolucionado con el tiempo con el uso creciente de un implante más rígido y un aumento resultante en las tasas de consolidación. Sin embargo, complicaciones como la irritación de los tendones extensores han llevado al desarrollo e introducción de implantes mejorados de bajo perfil en los últimos años. Este estudio tuvo como objetivo examinar los factores que influyen en la curación de la artrodesis total de la muñeca y la frecuencia de complicaciones utilizando una placa de bajo perfil del mismo fabricante. Materiales y métodos Se trata de un estudio retrospectivo que analiza las historias clínicas y radiografías de pacientes sometidos a artrodesis de muñeca utilizando una placa de fusión de muñeca Aptus® 2.5 Trilock larga o corta (Medartis AG, Basilea, Suiza) entre 2015 y 2021 en el mismo hospital. Se analizaron variables epidemiológicas y clínicas. La prueba de Chi-cuadrado o Prueba exacta de Fischer se utilizó para comparar las proporciones y los resultados, con un valor p ≤ 0,05 que se considera estadísticamente significativo. Resultados De las 85 artrodesis de muñeca realizadas, se observó una consolidación del 100% en un promedio de 4,6 meses después de la cirugía. La mayoría de los pacientes eran no fumadores (80%), hombres (69,4%), con una edad media de 50,7 años. La tasa de complicaciones fue del 10,5%, todas las cuales se resolvieron después de una intervención adicional, requiriendo solo una extracción del implante. El tiempo medio de consolidación en los fumadores fue de 5,8 meses y en los no fumadores de 4,2 meses (p = 0,03). El tiempo medio de consolidación después de los procedimientos de placa larga fue sutilmente más corto que con el uso de placa corta, pero no tuvo significación estadística. Conclusión Las artrodesis de la muñeca en el presente estudio tuvieron una tasa de consolidación del 100% con una baja tasa de complicaciones y sin diferencias en los resultados en cuanto a la colocación del injerto, la fusión de la articulación carpometacarpiana o los perfiles demográficos de los pacientes. Fumar se asoció con un mayor tiempo de consolidación, pero no condujo a la pseudoartrosis. Grado de comprobación IV

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“…In this context, studies have reported better results with the fourth generation of artificial wrist joints ( Bidwai et al, 2013 ; Froschauer et al, 2021 ). In contrast to wrist fusion, TWA preserves wrist mobility and provides effective pain relief ( Fischer et al, 2020 ; Berber et al, 2020 ; Matsui et al, 2020 ; Zhu et al, 2021 ). However, the carpal component still tends to loosen on long-term follow-up ( Reigstad et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of a novel three-dimensional printed microporous titanium prosthesis for total wrist arthroplasty in the treatment of end-stage wrist arthritis

Cai

Wang

Zhang

et al. 2023

Front. Bioeng. Biotechnol.

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Background: Total wrist arthroplasty is an effective treatment for end-stage wrist arthritis from all causes. However, wrist prostheses are still prone to complications such as prosthesis loosening and periprosthetic fractures after total wrist arthroplasty. This may be due to the wrist prosthesis imprecise matching with patient’s bone. In this study, we designed and developed a personalized three-dimensional printed microporous titanium artificial wrist prosthesis (3DMT-Wrist) for the treatment of end-stage wrist joint, and investigated its safety and effectiveness.Methods: Total wrist arthroplasty was performed using 3DMT-Wrist in 14 cases of arthritis between February 2019 and December 2021. Preoperative and postoperative visual analog scale scores, QuickDASH scores, wrist range of motion, and wrist grip strength were evaluated. Data were statistically analyzed using the paired samples t-test.Results: After 19.7 ± 10.7 months of follow-up, visual analog scale decreased from 66.3 ± 8.9 to 6.7 ± 4.4, QuickDASH scores decreased from 47.4 ± 7.3 to 28.2 ± 7.6, grip strength increased from 5.6 ± 1.4 to 17.0 ± 3.3 kg. The range of motion improved significantly in palmar flexion (30.1° ± 4.9° to 44.9° ± 6.5°), dorsal extension (15.7° ± 3.9° to 25.8° ± 3.3°), ulnar deviation (12.2° ± 3.9° to 20.2° ± 4.3°) and radial deviation (8.2° ± 2.3° to 16.2 ± 3.1). No dislocation or loosening of the prosthetic wrist joint was observed.Conclusion: Total wrist arthroplasty using 3DMT-Wrist is a safe and effective new treatment for various types of end-stage wrist arthritis; it offers excellent pain relief and maintains the range of motion.

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Salvage of the Failed Total Wrist Arthroplasty: A Systematic Review

Cited by 24 publications

References 22 publications

Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases

Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases

Artrodesis Total de la Muñeca con Placa Dorsal Bloqueada de Bajo Perfil y Ángulo Variable: Tasa de Consolidación y Complicaciones de 85 casos Consecutivos

Safety and efficacy of a novel three-dimensional printed microporous titanium prosthesis for total wrist arthroplasty in the treatment of end-stage wrist arthritis

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