Early Outcomes of Pyrolytic Carbon Hemiarthroplasty for the Treatment of Trapezial-Metacarpal Arthritis

Aragon, Javier S. Martinez de; Moran, Steven L.; Rizzo, Marco; Reggin, Kirsten B.; Beckenbaugh, Robert D.

doi:10.1016/j.jhsa.2008.10.018

Cited by 78 publications

(17 citation statements)

References 20 publications

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“…This shows improvement over previous prosthetic designs that had high failure rates, such as silicone, ceramic, cemented (in younger, active patients), and carbon fiber [1, 3, 13, 18, 20, 24, 25]. …”

Section: Discussionmentioning

confidence: 76%

“…Subluxation remained a problem with later use of a titanium implant [26]. Other investigators have found various other procedures that attempted to alleviate basal joint arthritis pain and improve function also ultimately were unsuccessful [1, 3, 13, 20, 24, 25]. …”

Section: Discussionmentioning

confidence: 99%

“…When nonoperative treatment fails, several surgical options are available. Several treatments have been offered, but none is uniformly successful [1, 3, 13, 20]. Trapeziometacarpal arthrodesis has been used occasionally, yet a solid radiographic union does not always occur and reported nonunion rates range from 5% to 50% [6, 11].…”

Section: Introductionmentioning

confidence: 99%

“…Implant arthroplasty has been performed for 45 years using various types of implant designs and materials, such as silicone, ceramic, polyethylene, and metal [1, 3, 4, 13, 18, 20, 24–26]. Swanson [24, 25] primarily was responsible for popularizing silicone implant arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

“…In 1981, Swanson et al [26] began using a titanium implant, but subluxation still occurred in several patients. Implant subluxation and high failure rates have been a problem with all previous prosthetic designs and implant materials [3, 18, 20, 25]. …”

Section: Introductionmentioning

confidence: 99%

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A Promising Thumb Basal Joint Hemiarthroplasty for Treatment of Trapeziometacarpal Osteoarthritis

Pritchett¹,

Habryl

2012

Clinical Orthopaedics &Amp; Related Research

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BackgroundTrapeziometacarpal joint osteoarthritis is a painful, disabling condition that primarily affects women who are postmenopausal. Arthroplasty has been performed to treat this condition; however, subluxation has been a problem with all previous implants. We report the results of hemiarthroplasty using a prosthesis designed to address the problems associated with previous implants.Questions/purposesWe wished to (1) determine if this prosthesis results in pain relief and functional improvement and preserves the appearance of the thumb, (2) assess the prosthetic reconstruction during followup, (3) assess complications that occur with the use of this prosthesis, and (4) determine the survivorship of this prosthesis.MethodsWe performed 159 basal joint hemiarthroplasties (138 patients) to treat osteoarthritis of the trapeziometacarpal joint. The mean age of the patients was 63 years, 78% were women, and all had Eaton-Littler Stage II or III changes. Only the damaged articular surfaces of the metacarpal and trapezium were excised; no tendon grafts or transfers were performed. Seven patients (seven thumbs) were lost to followup and seven (nine thumbs) died, leaving 124 patients (143 thumbs) for review. Clinical and radiographic assessments were made preoperatively, 12 weeks postoperatively, and annually thereafter. Minimum followup was 35 months (mean, 72.1 months; range, 35–120 months).ResultsAt latest followup, pain relief occurred in 135 thumbs, function improved in 138 thumbs, 139 thumbs were excellent or good in overall assessment, and 142 thumbs had good or excellent cosmetic appearance. The mean tip pinch improved from 4.9 kg preoperatively to 6.44 kg postoperatively. Mean postoperative Buck-Gramcko score was 49 (excellent); overall Kaplan-Meier analysis with revision as the end point showed 94% implant survivorship at a mean followup of 72.1 months.ConclusionsOur results are superior to those of other implants and support continued use of this implant. Studies with longer followup are required to confirm these results.Level of EvidenceLevel IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Promising Thumb Basal Joint Hemiarthroplasty for Treatment of Trapeziometacarpal Osteoarthritis

Pritchett¹,

Habryl

2012

Clinical Orthopaedics &Amp; Related Research

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Surgery for thumb (trapeziometacarpal joint) osteoarthritis

Wajon

Vinycomb

Carr³

et al. 2015

Cochrane Database of Systematic Reviews

189

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We did not identify any studies that compared surgery to sham surgery and we excluded studies that compared surgery to non-operative treatments. We were unable to demonstrate that any technique confers a benefit over another technique in terms of pain and physical function. Furthermore, the included studies were not of high enough quality to provide conclusive evidence that the compared techniques provided equivalent outcomes.

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