Trapeziometacarpal joint implants can be evaluated by roentgen stereophotogrammetric analysis

Background and purposeRadiostereometric analysis (RSA) is an accurate method for measurement of early migration of implants. Since a relation has been shown between early migration and future loosening of total knee and hip prostheses, RSA plays an important role in the development and evaluation of prostheses. However, there have been few RSA studies of the upper limb, and the value of RSA of the upper limb is not yet clear. We therefore performed a systematic review to investigate the accuracy and precision of RSA of the upper limb.Patients and methodsPRISMA guidelines were followed and the protocol for this review was published online at PROSPERO under registration number CRD42016042014. A systematic search of the literature was performed in the databases Embase, Medline, Cochrane, Web of Science, Scopus, Cinahl, and Google Scholar on April 25, 2015 based on the keywords radiostereometric analysis, shoulder prosthesis, elbow prosthesis, wrist prosthesis, trapeziometacarpal joint prosthesis, humerus, ulna, radius, carpus. Articles concerning RSA for the analysis of early migration of prostheses of the upper limb were included. Quality assessment was performed using the MINORS score, Downs and Black checklist, and the ISO RSAResults23 studies were included. Precision values were in the 0.06–0.88 mm and 0.05–10.7° range for the shoulder, the 0.05–0.34 mm and 0.16–0.76° range for the elbow, and the 0.16–1.83 mm and 11–124° range for the TMC joint. Accuracy data from marker- and model-based RSA were not reported in the studies included.InterpretationRSA is a highly precise method for measurement of early migration of orthopedic implants in the upper limb. However, the precision of rotation measurement is poor in some components. Challenges with RSA in the upper limb include the symmetrical shape of prostheses and the limited size of surrounding bone, leading to over-projection of the markers by the prosthesis. We recommend higher adherence to RSA guidelines and encourage investigators to publish long-term follow-up RSA studies.

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“…2014), and 5 studies involved the TMC joint (Hansen et al. 2010, Hansen et al. 2011, Hansen and Stilling 2013, Ooms et al.…”

Section: Resultsmentioning

confidence: 99%

“…(2010, 2013). In the first study (2010), 2 types of trapezium cups were analyzed using double examinations in both a phantom and a clinical study.…”

Section: Resultsmentioning

confidence: 99%

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The accuracy and precision of radiostereometric analysis in upper limb arthroplasty

et al. 2017

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“…The test may be with progressive load (push out test) or with cyclical loading. Loosening of the implant may be measured by visible loosening of the implant or giving through, and movement of the implant can be recorded indirectly from travel of the compression device and may also include analysis of micromotion of the implants using radiographic stereophotogrammetric analysis as described by Hansen et al [9].…”

Section: Resultsmentioning

confidence: 99%

Fixation of trapezial implants in a trapeziometacarpal total joint prosthesis tested in a model of porcine bone

Hansen

Hengst

Mortensen³

et al. 2011

Journal of Plastic Surgery and Hand Surgery

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High aseptic loosening rates have been reported in total joint prostheses of the carpometacarpal joint of the thumb, particularly in the trapezial component. The primary fixation of new implants may be tested in cadaver bones, but the anatomy of the pig is in many ways similar to that of the human, so we compared the central carpal bone from the forefoot of 6-month-old pigs, which has a saddle joint surface similar to the trapezium, to the trapezium in patients with carpometacarpal osteoarthritis. The mean (SD) bone mineral density of the 13 pig forefoot bones was 0.88 (0.12) g/cm(2) compared with 0.63 (0.16) g/cm(2) in the 31 human trapeziums. The measured size of the porcine bones was slightly larger than that of the human trapeziums. The similarity in form, size, and bone mineral density means that the central bone of the forefoot of 6-month-old pigs may be used for fixation tests in trapezial implants.

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“…However, with the use of uncemented cups, lack of osteointegration because of poor quality bone or fracture of osteointgration after intense or repetitive trauma has also been reported in the past 15. In a clinical study by Hansen et al 27. it was seen that trapeziometacarpal implants can be evaluated by roentgen streophotogrammetric analysis.…”

Section: Discussionmentioning

confidence: 99%

Outcome of uncemented trapeziometacarpal prosthesis for treatment of thumb carpometacarpal joint arthritis

Chug

Williams

Benn

et al. 2014

IJOO

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Background:Osteoarthritis of the trapeziometacarpal joint of thumb occurs frequently and can be very disabling. Numerous surgical techniques including trapeziectomy with or without tendon interposition arthrodesis and partial or total joint arthroplasty with cemented and noncemented prosthesis have been described for the treatment of trapeziometacarpal joint osteoarthritis. Initial problems of osteolysis and implant loosening have been substantially reduced with improvement in implant design. The aim of this study is to demonstrate that trapeziometacarpal osteoarthritis of the thumb can be effectively treated with uncemented total joint replacement prosthesis.Materials and Methods:We retrospectively collected data for 16 trapeziometacarpal joint replacements in 14 patients. One patient was excluded as they required revision with trapeziectomy and ligament reconstruction following fracture of Trapezium. The trapeziometacarpal joint prosthesis was used in all cases and all operations were carried out by one surgeon. Clinical outcome was determined by a pre and postoperative patient rated wrist evaluation (PRWE) and Michigan Hand Questionnaire Score. Range of motion, grip, tip pinch and key pinch strength were measured and compared with the unoperated hand. Radiological assessment was carried out by plain radiographs for preoperative staging of arthritis and postoperative radiographs at latest followup for evaluation of osteolysis and implant loosening. Average followup period was 26 months.Results:There was an improvement in hand function and pain level based on PRWE and Mischigan Hand outcome Questionnaire Score. One patient had intraoperative fracture of Trapezium and subsequent radiographs at 14 months followup showed loosening of the trapezial component due to nonunion of the fracture and complete disintegration of the trapezium. There were no cases of dislocation or implant loosening for the remaining 15 CMC joints at the latest followup.Conclusion:The use of uncemented prosthesis in treatment of Questionnaire Score. Range of motion joint osteoarthritis gives excellent short term results in improving hand function in terms of strength and stability and achieving pain relief.

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Trapeziometacarpal joint implants can be evaluated by roentgen stereophotogrammetric analysis

Cited by 15 publications

References 21 publications

The accuracy and precision of radiostereometric analysis in upper limb arthroplasty

The accuracy and precision of radiostereometric analysis in upper limb arthroplasty

Fixation of trapezial implants in a trapeziometacarpal total joint prosthesis tested in a model of porcine bone

Outcome of uncemented trapeziometacarpal prosthesis for treatment of thumb carpometacarpal joint arthritis

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