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Sökning: onr:"swepub:oai:DiVA.org:oru-67046" > Revision Arthroplas...

Revision Arthroplasty of the Wrist in Patients With Rheumatoid Arthritis, Mean Follow-Up 6.6 Years

Fischer, Per, 1981- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Department of Hand Surgery
Sagerfors, Marcus, 1977- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Region Örebro län, Department of Hand Surgery
Brus, Ole, 1982- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Clinical Epidemiology and Biostatistics
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Pettersson, Kurt, (författare)
Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
visa färre...
Örebro universitet Institutionen för medicinska vetenskaper. (creator_code:org_t)
Region Örebro län (creator_code:org_t)
2018
Engelska.
Ingår i: Journal of Hand Surgery-American Volume. - Elsevier. - 0363-5023. ; 43:5, s. 489.e1-489.e7
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • PURPOSE: Management of failed total wrist arthroplasty (TWA) can be challenging; surgical treatment options include salvage arthrodesis, revision arthroplasty, and resection arthroplasty. There are few studies regarding salvage arthrodesis, and revision arthroplasty has been infrequently investigated. The aim of the study was to report the outcome after revision arthroplasty of the wrist.METHODS: A retrospective cohort of 16 revision TWAs was evaluated between 2003 and 2016. Data were collected before surgery and 1 and 5 years after surgery. The indication for revision arthroplasty was failed TWA. The primary end point was implant survival. Secondary outcome measures included visual analog scale (VAS) pain scores, range of motion, handgrip strength, and functional scoring with the Canadian Occupational Performance Measure (COPM), Patient-Rated Wrist Evaluation (PRWE), and Disabilities of the Arm, Shoulder, and Hand (DASH).RESULTS: Mean follow-up was 6.6 years. Synthetic bone graft was used in 9 cases, allograft corticocancellous bone graft in 1 case, and cement in 6 cases. Of the 16 revision TWAs, 4 were re-revised, 1 because of infection, and 3 cases underwent total wrist arthrodesis. In the non-re-revised cases, range of motion and grip strength was preserved compared with preoperative results. The VAS pain score in activity improved, but not significantly, at 1 (median, 1; range, 0-4.5) and 5 years after surgery (median, 0) compared with before surgery (median, 5). The COPM performance and satisfaction as well as PRWE scores improved significantly at 1 year (median COPM performance, 4.8; COPM satisfaction, 5.6; and PRWE, 24) and improved, but not significantly, at the 5-year follow (median COPM performance, 4.8; COPM satisfaction, 5.0; and PRWE, 37) in the non-re-revised cases.CONCLUSIONS: Revision arthroplasty of the wrist is a valid motion-preserving option to wrist arthrodesis in the management of failed TWA. However, the outcome is uncertain and as many as 25% require additional surgery.TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopedics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Total wrist arthroplasty
osteoarthritis
rheumatoid arthritis

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Av författaren/redakt...
Fischer, Per, 19 ...
Sagerfors, Marcu ...
Brus, Ole, 1982-
Pettersson, Kurt
Om ämnet
MEDICIN OCH HÄLSOVETENSKAP
MEDICIN OCH HÄLS ...
och Klinisk medicin
och Ortopedi
MEDICIN OCH HÄLSOVETENSKAP
MEDICIN OCH HÄLS ...
och Klinisk medicin
och Kirurgi
Artiklar i publikationen
Journal of Hand ...
Av lärosätet
Örebro universitet

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