Short- to mid-term results of ulna head replacement as both a primary and revision implant

Baring, Toby; Popat, Ravi; Abdelwahab, Ali; Ferris, Barry

doi:10.1016/j.jcot.2016.04.005

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…20 As encouraging as these results are, only a minority of the patients in these reviews had preexisting wrist fusions. Many DRUJ arthroplasty studies have included a small number of patients with concomitant wrist fusion, [28][29][30][31][32] but no sub-analysis of this group of patients has been provided in these studies. [33][34][35][36][37][38] Von Groningen and Schuurman reported on six patients with a mean follow-up of 24 months with radioscapholunate fusion with ulnar head replacement after wrist arthritis due to distal radius fractures.…”

Section: Discussionmentioning

confidence: 99%

Outcomes following Distal Radioulnar Joint Arthroplasty in the Setting of Total or Partial Wrist Fusion

et al. 2022

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Purpose To evaluate the functional outcome and complications following primary ulnar head or total distal radial ulnar joint (DRUJ) arthroplasty in patients who have a partial or total wrist fusion. Methods We conducted a retrospective review of 33 primary DRUJ implants in 31 patients who had a partial or total wrist fusion. Follow-up time averaged 67 months. There were 11 partial and 22 total wrist fusions with 22 ulnar head prosthesis and 11 total DRUJ implants. The mean age of the patients was 49 years. Eighty-one percent had previous surgeries with an average number of 4.6 previous wrist procedures. Pre- and postoperative pain levels were recorded. Mayo Wrist Scores were calculated. Grip strength, range of motion (ROM), and post-operative complications were noted. Results The pain scores improved in 67% of the patients. The Mayo Wrist Score improved significantly from a mean of 39 preoperatively to 51 postoperatively. The grip strength and pro-supination remained stable. The wrist ROM also remained stable in the patients with partial wrist fusions. During the follow-up period, 10 (30%) of the DRUJ implants were explanted, with a trend toward higher explantation rates in total wrist fusions with one in the partial fusion group and nine in the total wrist fusion group. Four of the explantations happened in the first postoperative year. Nineteen (61%) of the patients required a second surgery for a DRUJ implant-related complication; this rate was similar between the partial and total fusion groups. Conclusions DRUJ replacement resulted in improved pain scores and Mayo wrist scores in the majority of patients; however, the combination of primary DRUJ arthroplasty and total wrist fusion was associated with high complication rates. Surgeons should be aware of the high complication rate seen with DRUJ arthroplasty when combined with total wrist fusion.

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Section: Discussionmentioning

confidence: 99%

Outcomes following Distal Radioulnar Joint Arthroplasty in the Setting of Total or Partial Wrist Fusion

et al. 2022

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“…Periprosthetic bone resorption and radiological instability after ulna head replacements have been described in the literature. 3 5 6 8 9 To further explore these phenomena, we compared two different prosthetic concepts: the total and partial ulna head replacements.…”

Section: Discussionmentioning

confidence: 99%

“… 1 The clinical reports are few and the outcome of the various implants are mostly based on small, retrospective case series. 1 2 3 4 5 6 7 8 Most series report improved function, effective pain relief and preserved forearm rotation in most patients, and an implant survival of 90 to 100% 5 years postoperatively. 1 9 Radiographic phenomena, such as periprosthetic bone resorption and implant subluxation are frequently being described.…”

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confidence: 99%

Bone Remodeling after Ulna Head Replacement in Distal Radioulnar Joint Arthroplasty: A Radiographic Comparison between a Partial and a Total Ulna Head Concept

2022

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Background Ulna head arthroplasty has become an eligible solution for injury or disease in the distal radioulnar joint. Bone resorption beneath the prosthetic head is often reported, but mechanism poorly understood. Purpose The aims were to evaluate bone remodeling and radiological instability in two conceptually different distal radioulnar joint arthroplasties: the total and the partial ulna head replacement. Patients and Methods We conducted a retrospective radiographic assessment of 51 ulna head arthroplasties; 26 Herbert ulna (total ulna head replacement) and 25 First Choice (partial ulna head replacement), to analyze periprosthetic bone resorption and radiologic instability. Intraoperative/immediate postoperative and 1-year radiographs were reviewed by two independent assessors. The radiographic follow-up averaged 13 (10–17) months. The size of the stem in relation to the diameter of the ulna (filling ratio) was measured on the intraoperative/immediate postoperative radiographs. Bone resorption beneath the collar of the prothesis was measured on the 1-year radiographs and expressed as a bone resorption index (BRI) between the length of the resorption and the length of the implant stem. Radiological stability was measured on both the preoperative and the 1-year lateral radiographs. Results The total ulna head prothesis presented with more extensive bone resorption beneath the prosthetic head than the partial ulna head prothesis at 1-year post surgery (p <0.001). The filling ratio did not influence the 1-year bone resorption and there was no difference regarding radiological instability between the two prosthetic designs. Conclusion The pattern of bone adaptions after an ulna head prothesis may differ due to design and concept of the prosthesis.

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“…Some reports have shown favorable outcomes with these procedures; however, they fail to restore normal joint kinetics and stability. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Ulnar head hemiarthroplasty, with preservation of the foveal insertion, has offered the possibility of pain relief and improved forearm kinematics in patients with DRUJ arthritis. Partial ulnar head hemiarthroplasty within the United States is limited to metal implants.…”

mentioning

confidence: 99%

“…Some reports have shown favorable outcomes with these procedures; however, they fail to restore normal joint kinetics and stability. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15…”

mentioning

confidence: 99%

Comparative Analysis of Two Hemiarthroplasty Techniques for Symptomatic Distal Radial Ulnar Joint Arthritis

Hebel,

Wu,

Helsper

et al. 2024

J Wrist Surg

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Background Hemiarthroplasty may be indicated for patients with distal radioulnar joint (DRUJ) arthritis. Recently, the use of the pyrocarbon metacarpophalangeal implant has been proposed as a novel means of treating DRUJ arthritis due to the materials improved mechanical properties and wear characteristics. Purpose and Questions This study compares midterm outcomes of metallic and pyrocarbon hemiarthroplasties for the treatment of symptomatic DRUJ arthritis. Questions of interest included outcomes and complications. Patients and Methods In total, 32 hemiarthroplasties, 10 metallic and 22 pyrocarbon, were performed between 2010 and 2020 by three surgeons at one tertiary medical center. Patients' retrospective outcomes were extracted from the electronic medical record. Results Postoperatively, the metallic implant group (mean follow-up: 38 months) demonstrated decreased pain but no changes in range of motion. Comparatively, the pyrocarbon group experienced an improved range of motion and postoperative pain (p < 0.05). Radiographic analysis demonstrated 10% of metallic implants and 9% of pyrocarbon implants to have resulted in thinning of the lateral cortex of the radius at the final follow-up. Minor complications in metallic and pyrocarbon implant groups warranting reoperation occurred at rates of 10 and 13.5% while implant failure occurred at a rate of 30 and 18%, respectively. Discussion Within this study, pyrocarbon implants resulted in significant functional improvement with comparable complication and failure rates to the metallic implant. Long-term stability demonstrated efficacy for both techniques in symptomatic DRUJ treatment. Type of Study/Level of Evidence Observational Case Series IV.

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Short- to mid-term results of ulna head replacement as both a primary and revision implant

Cited by 6 publications

References 22 publications

Outcomes following Distal Radioulnar Joint Arthroplasty in the Setting of Total or Partial Wrist Fusion

Outcomes following Distal Radioulnar Joint Arthroplasty in the Setting of Total or Partial Wrist Fusion

Bone Remodeling after Ulna Head Replacement in Distal Radioulnar Joint Arthroplasty: A Radiographic Comparison between a Partial and a Total Ulna Head Concept

Comparative Analysis of Two Hemiarthroplasty Techniques for Symptomatic Distal Radial Ulnar Joint Arthritis

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