Two-Year Clinical and Radiographic Evaluation of Scheker Prosthesis (Aptis) Distal Radioulnar Joint Arthroplasty

Brannan, Patrick; Ward, W. Alan; Gaston, R. Glenn; Chadderdon, Robert C.; Woodside, Julie Colantoni; Connell, Benjamin

doi:10.1016/j.jhsa.2021.04.034

Cited by 10 publications

(17 citation statements)

References 38 publications

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Section: Discussionsupporting

confidence: 90%

“…Our results regarding wrist and forearm motion, VAS pain score, grip strength, and survival ratio are comparable with those of Scheker et al, 12 Bizimungu and Dodds, 17 Bellevue et al, 28 Lambrecht et al, 2 Warlop et al, 13 and Brannan et al 23 Compared with other studies, our complication rate and surgical revision rate are relatively high and quite disappointing compared with previously conducted studies. 13,[22][23][24][25]27,28 Only Lans et al 26 reported a higher surgical revision rate of 50% due to pisotriquetral arthritis, most likely as a result of altered pisotriquetral joint dynamics. Lans et al 26 also reported that accurate placement of the radial component in the severely destroyed wrist is a tedious procedure and suggested placing the radial component as distal as possible for proper fitting along the ulnar side of the radius.…”

Section: Discussionsupporting

confidence: 88%

“…Previous conducted studies have shown promising short- and midterm functional outcomes, a high survival ratio, and considerable patient satisfaction. 13 14 15 16 17 18 19 20 21 However, in recent studies, 13 22 23 24 25 26 27 28 high complication rates and surgical revision rates (23–50%) are often debated. This discrepancy raises the question of whether the functional outcome, implant survival ratio, and patient satisfaction are valid indicators of the performance of the Aptis DRUJ arthroplasty.…”

mentioning

confidence: 99%

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Aptis Distal Radioulnar Joint Arthroplasty: A Multicenter Evaluation of Functional Outcomes, Complications, and Patient Satisfaction

Stougie,

Boekel,

Beumer

et al. 2023

J Wrist Surg

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Background The Aptis distal radioulnar joint (DRUJ) implant has been commonly used to replace the DRUJ and restore wrist function in patients with a severely destroyed DRUJ. Objective Promising results have been described in the literature. However, the clinical results in a multicenter setting are sparse and variable. This study evaluates the short- to midterm clinical results of 53 patients with a (mean) follow-up of 51 months. Patients and Methods Fifty-three patients (59 implants) treated between 2011 and 2020 in three different institutions were retrospectively identified in a prospectively collected database. The main indication for Aptis DRUJ arthroplasty was a destroyed DRUJ and gross distal radioulnar instability and isolated DRUJ osteoarthritis. Functional outcome, complications, and patient satisfaction were evaluated. Patients completed the Patient-Rated Wrist Evaluation (PRWE) questionnaire and an additional questionnaire about patient satisfaction and return to hobby/work. Results Implant survival was 92%, the surgical follow-up showed many complications (64,4%), and revision surgery was needed frequently (40.7%). In 13 cases, the follow-up was longer than 5 years. Three reimplantations had to be performed and two implants were permanently explanted. In spite of this all, wrist and forearm motion as well as pain reduction was adequate and patient satisfaction was reasonable (72.2%). Conclusion The Aptis DRUJ arthroplasty is a viable option that can provide adequate wrist and forearm function after secure patient selection and surgical placement of the implant in the wrist with a good bone stock of the radius. The complication rate was found to be high, yet patient satisfaction was reasonable. In the case of secondary surgery, additional surgery seems to be needed. For primary surgery, the implant seems to be successful without complications. Different complications have been described, but further analysis is warranted to find the causes of complications and to objectify the performance of the Aptis DRUJ implant. Level of Evidence IV.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

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Aptis Distal Radioulnar Joint Arthroplasty: A Multicenter Evaluation of Functional Outcomes, Complications, and Patient Satisfaction

Stougie,

Boekel,

Beumer

et al. 2023

J Wrist Surg

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“…Minimal evidence-based guidance exists on the management of DRUJ arthritis after initial TWA. [20][21][22][23][24][25][26][27] Zachary and Stern examined both short-and long-term complications after TWA. They noted that only 1 patient out of 73 required a secondary surgery to address DRUJ arthritis at a mean of 1 year postoperative.…”

Section: Discussionmentioning

confidence: 99%

“…While other studies have not directly examined the correlation between TWA and DRUJ arthritides, 10 to 50% of patients undergoing DRUJ arthroplasty have been reported to have previously undergone TWA. [21][22][23][24] Conversely, it has been reported that 8 to 32% of patients who undergo a procedure addressing DRUJ first subsequently require arthrodesis to address the RC joint, including TWA or limited wrist arthrodeses. [25][26][27] Isolated or staged surgical management of concomitant RC and DRUJ arthritides may be preferred due to the challenges inherent to a single-stage surgery to address both arthritides.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Preoperative Asymptomatic or Minimally Symptomatic DRUJ Arthritis after Total Wrist Arthrodesis: A Single-Institution Case Series

2022

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Background Concomitant severe radiocarpal (RC) arthritis with asymptomatic or minimally symptomatic distal radioulnar joint (DRUJ) arthritis can be debilitating for patients. Surgical management of these combined arthritides can pose a dilemma for surgeons and patients. The purpose of this study was to evaluate patients with concomitant RC and DRUJ arthritides who underwent only total wrist arthrodesis (TWA) to determine the need for subsequent surgical management of preoperative asymptomatic/minimally symptomatic DRUJ arthritis. Materials and Methods All patients who underwent TWA between 2008 and 2018 at a single institution were evaluated. Those patients who underwent TWA for degenerative, inflammatory, or posttraumatic arthritis with concomitant asymptomatic or minimally symptomatic DRUJ arthritis preoperatively were included. A retrospective review was performed for demographic variables, TWA indications, pre- versus post-TWA DRUJ symptoms, and severity of DRUJ arthritis on radiographs. Primary outcome measure was survivorship from subsequent DRUJ surgery for development of symptomatic arthritis after initial TWA. Results One hundred and eighty-three patients underwent TWA during the study period, of which 39 wrists met inclusion criteria. Indications for TWA included posttraumatic arthritis (n = 22), avascular necrosis of the lunate (n = 10), and inflammatory arthritis (n = 7). The mean clinical follow-up was 5.7 years (range: 1.5–12.7 years). Four patients (10%) who underwent TWA ultimately required a subsequent procedure to address DRUJ arthritis at a mean time of 20 months (range: 3–60 months) after initial TWA. The initial indication for TWA in these patients included symptomatic posttraumatic arthritis (n = 3) and lunate avascular necrosis (n = 1). Conclusion In patients with symptomatic RC and asymptomatic or minimally symptomatic DRUJ arthritides undergoing TWA alone, 10% in this series required subsequent surgical management for progressive DRUJ arthritis. Clinical Relevance Surgical management of concomitant symptomatic RC and asymptomatic/minimally symptomatic DRUJ arthritides with TWA alone is a reasonable initial approach. Patients should be counseled preoperatively that subsequent surgical management of progressive DRUJ arthritis may be necessary in ∼10% of patients.

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Replacement of the distal radio-ulnar joint with a semi-constrained Scheker DRUJ prosthesis

Jawahier,

Derksen,

Jaquet

et al. 2023

Oper Orthop Traumatol

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Two-Year Clinical and Radiographic Evaluation of Scheker Prosthesis (Aptis) Distal Radioulnar Joint Arthroplasty

Cited by 10 publications

References 38 publications

Aptis Distal Radioulnar Joint Arthroplasty: A Multicenter Evaluation of Functional Outcomes, Complications, and Patient Satisfaction

Aptis Distal Radioulnar Joint Arthroplasty: A Multicenter Evaluation of Functional Outcomes, Complications, and Patient Satisfaction

Outcome of Preoperative Asymptomatic or Minimally Symptomatic DRUJ Arthritis after Total Wrist Arthrodesis: A Single-Institution Case Series

Replacement of the distal radio-ulnar joint with a semi-constrained Scheker DRUJ prosthesis

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