The Influence of Subluxation on the Severity of Symptoms, Disability, and the Results of Operative Treatment in TMC Osteoarthritis with Total Joint Arthroplasty

Larsen, Solveig Kärk Abildtrup; Østergaard, Ann Mai; Hansen, Torben Bæk

doi:10.1007/s11552-015-9765-8

Cited by 4 publications

(3 citation statements)

References 23 publications

(27 reference statements)

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“…Newer studies revealed that the radiographic staging for severity of CMCJ I OA by Eaton-Littler (1973) and Eaton-Glickel (1987) alone are likely unable in decision making which treatment would be appropriate. Thus, it has been recommended to introduce a new classification that incorporates more the preoperative patient's disability; and diagnosis and treatment should be based on the surgeon's qualitative assessment combining history, physical examination, the patients claims in activities of daily living, radiographic evaluation, surgical experience of the treating physicians, and subjective patients factors [9,[39][40][41][42][43][44]. Moreover, psychological factors or disorders of the patients may have influence on the outcome after treatment of CMCJ I OA [45,46].…”

Section: Discussionmentioning

confidence: 99%

Trapezial dysplasia and concomitant disorders around the thumb can influence the outcome after total carpometacarpal joint replacement: Report of two cases, short review of literature, and update to the Arpe™ prosthesis

Schmidt¹

2021

Trauma Emerg Care

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The thumb carpometacarpal joint is the most common site of osteoarthritis in the hand with post-menopausal female predominance, and it can be associated with trapezial dysplasia. For treatment of osteoarthritis the use of the Arpe TM prosthesis has proven to be a useful and reliable option with a remarkable long-term survivorship and a high patient satisfaction. However, several initially undiagnosed concomitant or secondarily occurred disorders at the thumb may have negative influence on the outcome, and it can lead to a false diagnosis "failed total thumb carpometacarpal joint replacement". In the presence of trapezial dysplasia, an exact preoperative planning is absolutely necessary to avoid postoperative dislocation of the implant.

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Section: Discussionmentioning

confidence: 99%

Trapezial dysplasia and concomitant disorders around the thumb can influence the outcome after total carpometacarpal joint replacement: Report of two cases, short review of literature, and update to the Arpe™ prosthesis

Schmidt¹

2021

Trauma Emerg Care

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“…A tip pinch of 1 kg will generate 12 kg joint compression; and for the power grip, the load may be as high as 120 kg [25]. Additionally, recent evidence suggests that cup surveillance does not depend on the preoperative radiographic staging using the classifications by Eaton-Littler (1973) or Eaton-Glickel (1987); thus, for assessment the outcome of total TCMJ replacement it has been recommended in 2015 by Larsen et al [26] to introduce a new classification that incorporates more the preoperative patient's disability. When using non-cemented screw cups, it is also recommended to insert it without threading of the trapez bone to improve the primary insertion-related stability that is an important prerequisite for its secondary bony anchorage [27,28].…”

mentioning

confidence: 99%

Combined replacements of the wrist, ulnar head, and thumb carpometacarpal joint. Case report, technical note and recent evidence to the Arpe™ prosthesis

Schmidt¹

2017

Trauma Emerg Care

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“…That can be based either on long duration of symptoms or occult painful osteoarthritis in DRUJ that does not always correlate with the radiographic findings which is well known from other joints such as the carpometacarpal joint of the thumb (i.e. rhizarthrosis) [40,75]. For those cases it is recommended to take a osteocartilage specimen for histological examination while performing the USO that can be helpful for evaluation of postoperative discomfort (Figures 4 and 5).…”

mentioning

confidence: 99%

Who introduced the "quadrangular-construct" modification of the Sauvé Kapandji procedure first? Case presentation and brief overview of literature with regard to general, specific and practicable aspects to primary trauma-related surgical treatment including possible salvage options at the distal radioulnar joint

Schmidt¹,

Schmitz²,

Muradyan³

et al. 2017

Trauma Emerg Care

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A 26-year-old male sustained a left wrist injury after an occupational fall from height that was diagnosed as wrist sprain and treated conservatively by a plaster splint in another institution. Eight weeks after injury, the patient could be re-employed in his original occupation as a truck driver. Six years after injury, the patient came in our institution for the first time, and reported increasing pain in his left wrist accompanied with marked restriction of his left forearm's supination and pronation leading to the non-ability to carry out his occupational job 8 weeks previously. On clinical examination, there was pronounced dorsal subluxation of the ulnar head without any given possibilities for it manual closed reduction (i.e. static instability in transverse plane) ( Figure 1A). Posterior-anterior (PA) radiographs of both wrists showed no concomitant ulnar positiv variance (UPV) (i.e. no longitudinal instability) and no posttraumatic arthritic changes in the distal radioulnar joint (DRUJ), but the configuration of the ulnar styloid at the formerly injured left wrist could not be well assessed that suggested an additional rotation deformity of the ulnar head ( Figure 1B). Lateral radiographs of both wrist showed marked fixed subluxation of the ulnar head in dorsal direction (i.e. static instability in transverse plane) ( Figure 1C). Due to these findings, the Sauvé-Kapandji procedure, modified by creating a "quadrangularconstruct", was detected by us. At the preoperative radiographs of the left elbow in both planes there were no signs of any pre-existing degenerative changes with specific regard to the radiocapitellar joint.Intraoperatively, first, the 2 cm long ulna segment was excised typically proximal to the DRUJ, then a Kirschner-wire was drilled into the ulnar head parallel to the plane of the operation table on which the left forearm was positioned at terminal range of pronation (i.e. 90°) ( Figure 2A). After that, the ulnar head was rotated 90° perpendicular to the operation table's plane in dorsal direction using the formerly drilled Kirschner-wire, and so the neutral position of DRUJ could be achieved in which the arthrodesis had to be performed ( Figure 2B). Then, the cartilage of both corresponding surfaces in DRUJ was excised, and the DRUJ arthrodesis in neutral position was carried out using a 3.5 mm titanium malleolar screw, and the Kirschner-wire was removed. The next step included the several years later introduced "quadrangularconstruct" modification of the original Sauvé-Kapandji procedure: After decorticalization of the corresponding radius and ulna shafts proximal to the DRUJ arthrodesis and distal to resection plane of the ulna segment, the formerly excised ulna segment has been inserted transversely between both forearm bones and fixated with a second 3.5 mm titanium cortical screw through the ulna segment graft, and finally, complete restoration of rotation motion arc could be achieved ( Figures 2C-D). The correctly performed surgical procedure was confirmed intraoperatively by flu...

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The Influence of Subluxation on the Severity of Symptoms, Disability, and the Results of Operative Treatment in TMC Osteoarthritis with Total Joint Arthroplasty

Cited by 4 publications

References 23 publications

Trapezial dysplasia and concomitant disorders around the thumb can influence the outcome after total carpometacarpal joint replacement: Report of two cases, short review of literature, and update to the Arpe™ prosthesis

Trapezial dysplasia and concomitant disorders around the thumb can influence the outcome after total carpometacarpal joint replacement: Report of two cases, short review of literature, and update to the Arpe™ prosthesis

Combined replacements of the wrist, ulnar head, and thumb carpometacarpal joint. Case report, technical note and recent evidence to the Arpe™ prosthesis

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