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Radiographic evaluation of osseointegration and loosening of titanium implants in the MCP and PIP joints

Möller, Karin, 1962 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för kirurgi,Institute of Surgical Sciences, Department of Surgery
Geijer, Mats, 1957 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för särskilda specialiteter, Avdelningen för radiologi,Institute of Selected Clinical Sciences, Department of Radiology
Sollerman, Christer, 1946 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för ortopedi,Institute of Surgical Sciences, Department of Orthopaedics
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Lundborg, Göran (författare)
Lund University,Lunds universitet,Handkirurgi, Malmö,Forskargrupper vid Lunds universitet,Hand Surgery, Malmö,Lund University Research Groups
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 (creator_code:org_t)
Elsevier BV, 2004
2004
Engelska.
Ingår i: J Hand Surg [Am]. - : Elsevier BV. - 0363-5023 .- 1531-6564. ; 29:1, s. 32-8
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • PURPOSE: Good to excellent clinical results have been shown in the initial studies on osseointegrated metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint implants that consist of a flexible silicone spacer connected to osseointegrated titanium fixtures. A high fracture rate of the silicone spacer, however, has been reported, diminishing the value of this implant system. The purpose of this study was to evaluate the osseointegration of the titanium fixture itself in a large study group and compare patients with rheumatoid arthritis with those with osteoarthrosis as a base for further development of the implant concept. METHODS: Two hundred thirty-nine implants (27 PIP, 212 MCP) in 86 patients were retrospectively evaluated radiographically. Two hundred implants were in patients with rheumatoid arthritis. Radiographic evaluation included measuring the length and width of resorption zones around the titanium fixtures. A scoring system was used that grouped observations in 4 groups, from 0 (little or no change) to 3 (loosening). Status of the silicone spacer was also noted. RESULTS: At follow-up evaluation an average of 41 months (range, 12-103 months) after surgery, complete osseointegration was found in 450 of 478 fixtures (94%). Loosening was found in 10 proximal and 18 distal fixtures. The proximal fixtures showed loosening mainly during the first 3 years after surgery and the distal fixtures also had loosening. In the 31 MCP joint implants that were evaluated for more than 5 years, the osseointegration rate was 97%. CONCLUSIONS: Implant stem fixation with osseointegrated titanium fixtures is a valuable method that works well in rheumatoid arthritis patients. Further development will focus on a more durable constrained joint mechanism.

Ämnesord

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

Nyckelord

Adolescent
Adult
Aged
Aged
80 and over
Arthritis
Rheumatoid/surgery
*Arthroplasty
Equipment Failure Analysis
Female
Finger Joint/*radiography/*surgery
Humans
*Joint Prosthesis
Male
Middle Aged
*Osseointegration
Osteoarthritis/surgery
*Prosthesis Failure
Retrospective Studies
Silicone Elastomers
Titanium
hand surgery
osseointegration
arthroplasty

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