Complications of Aptis DRUJ Arthroplasty

Abstract

Figure 21-1: A 45-year-old man with stage IIIA disease. (A) Posteroanterior radiograph. (B) Preoperative wrist bone scan. Figure 21-2: (A) Bone scan at 5-months post-operatively, showing increased signal in the carpus. (B) Posteroanterior radiographs 12 years after surgery. The patient has no pain and excellent clinical outcome, according to the modified Mayo score. BIBLIOGRAPHY 1. Illarramendi AA, Schulz C, De Carli P. The surgical treatment of Kienböck's disease by radius and ulna metaphyseal core decompression.

Aseptic loosening of an APTIS distal radioulnar joint arthroplasty – Case report

“…The DRUJ functions as a stabilizer of the wrist, allows force transmission across the wrist to the forearm, and allows supination and pronation of the forearm [8]. Painful dysfunction and instability of the DRUJ has a dramatically negative impact on the ability to perform activities of daily living.…”

“…Painful dysfunction and instability of the DRUJ has a dramatically negative impact on the ability to perform activities of daily living. Several strategies to relieve DRUJ pain and instability have been documented in the literature, including distal ulnar replacement [3,8] and allograft reconstruction [5] with varying results/clinical outcomes. DRUJ implants are treatment options once other more conservative treatments that preserve the ulnar head, such as osteotomies, ligament reconstructions, and triangular fibrocartilage reconstructions, have been unsuccessful in lessening the patient's pain [5].…”

“…The APTIS arthroplasty has been documented in the literature with at least a 95% survival rate over five years and few failures have been published [5,8]. In a recent retrospective study, it was reported that 35% (18/51) of patients with an APTIS DRUJ arthroplasty required revision surgeries within eight years of initial implantation to relieve their pain [8].…”

“…The APTIS arthroplasty has been documented in the literature with at least a 95% survival rate over five years and few failures have been published [5,8]. In a recent retrospective study, it was reported that 35% (18/51) of patients with an APTIS DRUJ arthroplasty required revision surgeries within eight years of initial implantation to relieve their pain [8]. Out of the 18 complications, only one patient required an explant and one-bone forearm fusion, as the most common complication was periprosthetic fracture, which was treated by open reduction and internal fixation (ORIF) [8].…”

“…In a recent retrospective study, it was reported that 35% (18/51) of patients with an APTIS DRUJ arthroplasty required revision surgeries within eight years of initial implantation to relieve their pain [8]. Out of the 18 complications, only one patient required an explant and one-bone forearm fusion, as the most common complication was periprosthetic fracture, which was treated by open reduction and internal fixation (ORIF) [8]. Aseptic loosening of the APTIS DRUJ prosthesis was, also, reported as a possible complication within eight years of the initial implantation, but aseptic loosening has not been reported to occur in patients as early as five months after implantation, as we report in this case [8].…”