Hemi and total wrist arthroplasty

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MARC

Fischer, Per,1981-Örebro universitet,Institutionen för medicinska vetenskaper (author)

Hemi and total wrist arthroplasty

BookEnglish2019

Publisher, publication year, extent ...

Örebro :Örebro University,2019
83 s.
electronicrdacarrier

Numbers

LIBRIS-ID:oai:DiVA.org:oru-76146
ISBN:9789175292984
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-76146URI

Supplementary language notes

Language:English
Summary in:English

Part of subdatabase

SwePubSwePub

Classification

Subject category:vet swepub-contenttype
Subject category:dok swepub-publicationtype

Series

Örebro Studies in Medicine,1652-4063 ;198

Notes

Aim: To study implant survival and implant loosening following primary total wrist arthroplasty (TWA) using four different implants. To report outcome following wrist revision arthroplasty. To evaluate a new radial wrist hemi arthroplasty (RWHA) design clinically and biomechanically.Method: The studies included 136 primary TWAs and 16 revision TWAs, both studies with prospectively collected data. Six fresh frozen cadaveric wrist specimen were used for biomechanical analysis. The RHWA was evaluated clinically in a pilot series of 20 cases.Results: Total implant survival was 92% but with high frequency of implant loosening of surviving Re-Motion implants. None of the surviving Maestro implants were considered radiographically loose. Implant survival following revision arthroplasty was 75%, considerably lower than following primary TWAs. However, none of the patients with surviving revision implants had pain at rest and little or no pain in activity. The surgical procedure and placement of the RHWA was feasible. Overall, the kinematic and functional changes appeared acceptable compared to the native wrist. None of the patients underwent revision following RHWA but reoperation was performed in 7 patients on the indication of persistent pain. However, patients reported relief of pain and improvement of patient-reported outcome measures.Conclusion: High long-term implant survival and no signs of radiographic loosening was found for the Maestro implant. However, the Maestro implant is no longer available on the market and we believe there is a need for new TWA designs. Revision arthroplasty is a valid option in the management of failed TWA. However, implant survival is lower than for primary TWAs and as many as 25% require additional surgery. Promising results were found using the new RHWA design but the implant needs modification before further testing.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Rheumatoid arthritis
Wrist
Arthroplasty
Implant survival
Biomechanics

Added entries (persons, corporate bodies, meetings, titles ...)

Pettersson, Kurt,docentÖrebro University Hospital. Örebro, Sweden (thesis advisor)
Sagerfors, Marcus,PhD,1977-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län(Swepub:oru)msss (thesis advisor)
Fridén, Jan,professorInstitutionen för kliniska vetenskaper, Sahlgrenska akademien, Göteborgs Universitet (opponent)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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