Twenty-Year Experience With Primary Distal Radioulnar Joint Arthroplasty From a Single Institution

Amundsen, Asgeir; Rizzo, Marco; Berger, Richard A.; Houdek, Matthew T.; Frihagen, Frede; Moran, Steven L.

doi:10.1016/j.jhsa.2022.02.014

Cited by 7 publications

(12 citation statements)

References 35 publications

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“…Metallic implants have been shown to have a potential lifespan of over 10 years, but complication rates are still high. [23][24][25][26][27][28]38 Pyrocarbon has improved mechanical proprieties to avoid some of the complications seen with metal implants and has been employed as a DRUJ implants in Europe but not in the United States. [31][32][33][34][35][36][37] Comparative evaluation of these observed and theoretical outcomes is necessary for the improvement of surgical management of young and active patients with DRUJ arthritis.…”

Section: Discussionmentioning

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] 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…”

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confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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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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“…In the last decade, high complication rates and surgical revision rates (23–50%) have been reported [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Common complications reported are periprosthetic fracture, pisotriquetral arthritis [ 16 ], infection [ 17 ], periprosthetic extensor tendon, and extensor compartment problems [ 10 , 13 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Performance of the Aptis Distal Radioulnar Joint Implant: A Clinical Case Series Including Four-Dimensional Computed Tomography Kinematic Analysis

Stougie,

van Doesburg,

Oonk

et al. 2023

JCM

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High complication rates and surgical revision rates following Aptis implant placement have been reported in the literature. This study evaluates the performance of the Aptis implant of twelve patients using four-dimensional kinematic analysis. The (mean) follow-up was 58 months. Wrist motion, grip strength, and kinematic analysis of both arms were used to investigate possible causes of the reported complications. In nine cases (75%), the proximal to distal translation of the distal radius along the ulnar axis in the affected forearm was too little or absent. Significant correlations were found between postoperative extension and translation of the distal radius along the ulnar axis and between the radial deviation and combined error. The four-dimensional kinematic analysis suggests that the current design of the implant could lead to limited restoration of the position of the forearm rotation axis and the translation of the radius along the ulnar axis.

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“…positive clinical results, high survival rates, high patient satisfaction, and yet a high incidence of complications and revision surgery are reported. [3][4][5][6][7][8][9][10][11][12] Stougie et al 4 proposed that the current design of the implant could lead to limited proximal-distal translation of the radius along the ulnar axis during pronation-supination motion and displacement of the forearm rotation axis and may explain the possible causes for complications and revision surgery.…”

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confidence: 99%

Aptis Distal Radioulnar Joint Implant: Management of Remarkable Complications

Stougie,

Kemme,

Coert

et al. 2024

J Wrist Surg

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Background The aim of an Aptis distal radioulnar joint (DRUJ) implant is to reconstruct the DRUJ in patients with a destroyed, painful DRUJ, and gross ulnar instability. The literature is scarce regarding the management of (severe) early complications related to the Aptis implant in wrists with more rare conditions, such as rheumatoid arthritis, congenital malformations, or leiomyosarcoma of the distal ulna. Purpose This paper describes the clinical results, (severe) early complications related to the implant, revision surgery, patient satisfaction with the revision surgery, and esthetic appearance of the affected wrist in this specific cohort. Patients and Methods Retrospective evaluation of five consecutive patients with a short-to-medium follow-up time of 32 months (range: 18–53 months) was carried out. Results The follow-up revealed implant osseointegration failure in two cases, periprosthetic fractures in two cases, and acute carpal tunnel syndrome in one case. Three Aptis DRUJ arthroplasties were converted into a proximal Darrach. In four cases (80%), the patient was satisfied with the revision surgery due to pain reduction. In four cases (80%), the esthetic appearance of the affected wrist was found disappointing. Conclusion This study describes remarkable complications related to the Aptis implants in wrists with more rare conditions. The implant is more likely to fail in wrists with poor bone stock, remodeling of the radius, deformation, and malformation of the radius. The range of indications for the usage of the implant to maintain wrist function may be strict. Level of Evidence IV.

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Twenty-Year Experience With Primary Distal Radioulnar Joint Arthroplasty From a Single Institution

Cited by 7 publications

References 35 publications

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

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

Performance of the Aptis Distal Radioulnar Joint Implant: A Clinical Case Series Including Four-Dimensional Computed Tomography Kinematic Analysis

Aptis Distal Radioulnar Joint Implant: Management of Remarkable Complications

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