Arthroplasty of the Distal Radioulnar Joint Using a New Ulnar Head Endoprosthesis: Preliminary Report

Willis, Andrew A.; Berger, Richard A.; Cooney, William P.

doi:10.1016/j.jhsa.2006.12.004

Cited by 115 publications

(92 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21 The need for such a device serves as a warning against this deletive procedure. The total DRUJ replacement designed by Scheker 22 is an option for the unstable arthritic ulnar head; the potential advantage of resurfacing both sides of the joint in those with DRUJ arthritis should be balanced against the complexity and constrained mechanics of the device as well as the acceptable outcomes with simple hemiarthroplasty shown in this present series and that of Willis et al 19 Further developments for which peer reviewed results are awaited include preservation of the ulnar styloid (First Choice™; Ascension Orthopedics, Austin, TX, US) and pyrocarbon heads with theoretically less potential for erosion against the sigmoid notch (Eclypse™; Tornier, Montbonnot Saint Martin, France).…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Indications and early to mid-term results of ulnar head replacement

Warwick¹,

Shyamalan

Balabanidou

2013

annals

View full text Add to dashboard Cite

INTRODUCTION The aim of this study was to explore the indications and show the early to mid-term results of ulnar head replacement for the treatment of pathological conditions of the distal radioulnar joint. METHODS Our study group comprised 52 patients with a mean age of 64 years who had 56 ulnar head replacements. Seven were implanted to salvage an unstable deletive procedure; the rest were for primary treatment of osteoarthritis, rheumatoid arthritis and trauma. Concomitant procedures along with the ulnar head replacement included wrist arthrodesis, joint replacement and tendon transfers. RESULTS The follow-up duration ranged from 1 year to 11 years (mean: 60 months, median: 60 months). In almost all of the patients, pain improved with a median visual analogue scale score of 2 (mean: 2.2, range: 0-8) and a median DASH (Disabilities of the Arm, Shoulder and Hand) score of 12.5 (mean: 17.9, range: 0-56). Of the 52 patients, 47 reported they would have the same procedure again. CONCLUSIONS Ulnar head replacement appears to be a reliable and effective procedure solving several pathological problems of the distal radioulnar joint. We present a large patient group with a short to medium-term follow-up duration.

show abstract

Section: Discussionmentioning

confidence: 67%

“…Willis et al followed 19 uHead™ replacements (16 without previous ulnar head procedures) for 2 years and reported pain reduced by 50% and function improved threefold. 19 They reported two early failures. Yen Shipley et al reported on 20 Herbert or uHead™ replacements (six without previous procedures) followed for an average of 54 months.…”

Section: Discussionmentioning

confidence: 99%

Indications and early to mid-term results of ulnar head replacement

Warwick¹,

Shyamalan

Balabanidou

2013

annals

View full text Add to dashboard Cite

show abstract

“…Wolfe et al (1998) [28] reported satisfactory outcomes in 10/12 patients undergoing wide (25-50%) distal ulna excision and recent biomechanical analysis of interosseous membrane dynamics during progressive ulnar shortening has offered mechanical evidence to explain these outcomes [6,27]. Interestingly, [27]. Radioulnar synostosis, or creation of a one-bone forearm (OBF), represents the ultimate salvage procedure.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of a Self-Constrained Distal Radioulnar Joint Arthroplasty: A Case Series of Six Patients

Zimmerman

Jupiter

2011

Hand (New York, N,Y.)

View full text Add to dashboard Cite

“…24 Ulnar head prostheses have also been developed to restore the integrity of the DRUJ, which has been shown experimentally 6 and clinically. [25][26][27][28] Keywords ► distal radioulnar joint (DRUJ) ► osteoarthritis ► arthroplasty ► ulnar head resection ► ulnar head prosthesis …”

mentioning

confidence: 99%

Ulnar Head Replacement and Related Biomechanics

Sauerbier¹,

Arsalan-Werner

Enderle³

et al. 2013

Jnl Wrist Surg

View full text Add to dashboard Cite

Up to 30% of patients after distal radius fractures suffer from ulnar-sided wrist pain. 1 This is manifested in the form of wrist pain, restricted movement, weakness, and instability, even after correct reduction of the fracture and bony union. The integrity of the distal radioulnar joint (DRUJ) is necessary for stability and load transfer from the forearm to the wrist. [2][3][4] Osteoarthritis of the DRUJ may occur after trauma due to a bony deformity, a ligamentous injury, or combination of both. 1,5,16 In the surgical treatment of osteoarthritis, "salvage operations" are often necessary, in which the ulnar head is resected partially or completely. 7-10 Numerous clinical studies have demonstrated a reduction of painful clinical symptoms for all these techniques. 11-14 Biomechanically, even a partial resection of the distal ulna destabilizes the wrist, and clinically, it may lead to instability of the distal ulnar stump and the radius. 15,16 Distal radioulnar impingement occurs because the distal support of the radius for rotation and the "cam effect" of the distal ulna have been ablated. As a result, instability of the DRUJ may again lead to restriction of motion and strength as well as to increased pain. [17][18][19] To reduce DRUJ instability, various "soft tissue stabilization operations" have been developed. The most common techniques are the pronator quadratus-interposition flap (Johnson procedure) 20 and the extensor carpi ulnaris (ECU)-flexor carpi ulnaris (FCU) tenodesis (Breen-Jupiter tenodesis). [21][22][23] Biomechanical studies, however, show that these procedures do not provide adequate stabilization of the distal ulna. 24 Ulnar head prostheses have also been developed to restore the integrity of the DRUJ, which has been shown experimentally 6 and clinically. [25][26][27][28] Keywords ► distal radioulnar joint (DRUJ) ► osteoarthritis ► arthroplasty ► ulnar head resection ► ulnar head prosthesis AbstractA stable distal radioulnar joint (DRUJ) is mandatory for the function and load transmission in the wrist and forearm. Resectional salvage procedures such as the Darrach procedure, Bowers arthroplasty, and Sauvé-Kapandji procedure include the potential risk of radioulnar instability and impingement, which can lead to pain and weakness. Soft tissue stabilizing techniques have only limited success rates in solving these problems. In an attempt to stabilize the distal forearm mechanically following ulnar head resection, various endoprostheses have been developed to replace the ulnar head. The prostheses can be used for secondary treatment of failed ulnar head resection, but they can also achieve good results in the primary treatment of osteoarthritis of the DRUJ. Our experience consists of twenty-five patients (follow-up 30 months) with DRUJ osteoarthritis who were treated with an ulnar head prosthesis, with improvement in pain, range of motion, and grip strength. An ulnar head prosthesis should be considered as a treatment option for a painful DRUJ.

show abstract

Arthroplasty of the Distal Radioulnar Joint Using a New Ulnar Head Endoprosthesis: Preliminary Report

Cited by 115 publications

References 31 publications

Indications and early to mid-term results of ulnar head replacement

Indications and early to mid-term results of ulnar head replacement

Outcomes of a Self-Constrained Distal Radioulnar Joint Arthroplasty: A Case Series of Six Patients

Ulnar Head Replacement and Related Biomechanics

Contact Info

Product

Resources

About