Early Cup Loosening After Metal-on-Metal Total Joint Replacement of the Trapeziometacarpal Joint: A Retrieval Study

Thorkildsen, Rasmus; Johansson, Carina B.; Högmalm, Johan; Johansson, Pär; Røkkum, Magne

doi:10.1016/j.jhsa.2019.06.020

Cited by 11 publications

(3 citation statements)

References 142 publications

(169 reference statements)

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“…MoM articulations have mostly been abandoned in both the hip 32 and the smaller trapeziometacarpal joint. 27 We recommend discontinuing the use of MoM in TWA. Metal-on-PEEK, which is undocumented, and recently MoP, which is well documented in both the hip and wrist, are alternative articulations available for the Motec TWA.…”

Section: Discussionmentioning

confidence: 99%

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A randomized controlled trial comparing two modern total wrist arthroplasties

Holm-Glad

Røkkum

Röhrl

et al. 2022

The Bone & Joint Journal

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Aims To analyze the short-term outcome of two types of total wrist arthroplasty (TWA) in terms of wrist function, migration, and periprosthetic bone behaviour. Methods A total of 40 patients suffering from non-rheumatoid wrist arthritis were enrolled in a randomized controlled trial comparing the ReMotion and Motec TWAs. Patient-rated and functional outcomes, radiological changes, blood metal ion levels, migration measured by model-based radiostereometric analysis (RSA), bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), complications, loosening, and revision rates at two years were compared. Results Patient-Rated Wrist and Hand Evaluation (PRWHE) scores, abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire scores, and pain improved similarly and significantly in both groups. Wrist motion improved significantly in the Motec group only, and forearm rotation in the ReMotion group only. Cobalt (Co) and chromium (Cr) blood ion levels were significantly higher in the metal-on-metal (MoM) Motec group than in the metal-on-polyethylene (MoP) ReMotion group. Mean total translation was 0.65 mm (95% confidence interval (CI) 0.26 to 1.12) and 0.27 mm (95% CI 0.14 to 0.47) for the ReMotion carpal and radial components, and 0.32 mm (95% CI 0.22 to 0.45) and 0.26 mm (95% CI 0.20 to 0.34) for the Motec metacarpal and radial components, respectively. Apart from dorsal and volar tilts, which were significantly higher for the radial ReMotion than for the Motec component, no significant differences in absolute migration occurred. BMD around the radial components never returned to baseline. Almost one-third of patients required reoperation due to complications. Two ReMotion implants were revised to Motec TWAs due to carpal component loosening, and three Motec MoM articulations were revised to metal-on-polyether ether ketone due to painful synovitis. Conclusion Both implants provided matched function and were stable at short-term follow-up, but with a high complication rate. This procedure should be restricted to specialist centres undertaking prospective analysis until its role is clarified. Cite this article: Bone Joint J 2022;104-B(10):1132–1141.

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Section: Discussionmentioning

confidence: 99%

“…20,25,26 metal debris from a trapeziometacarpal mom articulation has been associated with massive osteolysis causing loosening of the trapezium component. 27 periprosthetic osteolysis is a well-known cause of late aseptic loosening in tha and tKa, 24 and is probably able to cause loosening of stable twas.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial comparing two modern total wrist arthroplasties

Holm-Glad

Røkkum

Röhrl

et al. 2022

The Bone & Joint Journal

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“…A variety of implantable devices have been described with varying results in the literature. 3,4,8,22 They can be divided into five groups on the basis of the classification described by Vitale. These include: 1) total joint replacement, 2) hemiarthroplasty, 3) interposition of implant with partial trapezial resection, 4) interposition of implant with complete trapezial resection and 5) interposition of implant with no trapezial resection.…”

Section: Implant-associated Proceduresmentioning

confidence: 99%