Functional and Radiographic Outcomes Following Distal Ulna Implant Arthroplasty

Kakar, Sanjeev; Swann, Russell P.; Perry, Kevin I.; Wood‐Wentz, Christina M.; Shin, Alexander Y.; Moran, Steven L.

doi:10.1016/j.jhsa.2012.03.026

Cited by 60 publications

(59 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Presumably, this is due to stress shielding. This has been commented on in other studies 17,[19][20][21] and seems to stabilise after about 6 months, although there are no studies, as yet, looking at the long-term effect of this bone loss. In the one patient who had the stem revised for a customised HAcoated implant, there was no radiological evidence of bone resorption at 43 months (see Fig.…”

Section: Discussionmentioning

confidence: 79%

“…The results obtained from our series suggest that this implant can provide patient satisfaction and symptom control with reasonable overall hand and forearm function when assessed at mid-term follow-up, a finding that is supported by other studies. [17][18][19][20] Obviously our results are specific to the Avanta implant and not necessarily representative of general DUR. Early results for this prosthesis have previously been published and showed encouraging results 16 with a 50% reduction in pain and a threefold improvement in function.…”

Section: Discussionmentioning

confidence: 81%

“…There is no trend of increasing resorption linked to a poorer result, although in a study of this size formal analysis is not possible. However, the re-absorption is extensive in some of our patients and there is a concern that eventually there will be risk of either aseptic loosening (which has been reported as a common cause for revision) 17 or peri-prosthetic fractures. At present, however, there is no evidence to support either risk or this is purely speculative.…”

Section: Discussionmentioning

confidence: 94%

“…partial replacement). 17,19,20 This may be due to our patient group being not only older and having lower demand, but it also may highlight the importance of selecting the correct implant size and taking care to reconstruct the soft tissue envelope, including re-attachment of the TFCC to the slot on the implant head. One patient did undergo revision at 20 months due to persistent pain (but not clinical instability) and required the head of the implant to be exchanged for a smaller size without revision of the stem.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Short- to mid-term results of ulna head replacement as both a primary and revision implant

Baring

Popat

Abdelwahab

et al. 2016

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Short- to mid-term results of ulna head replacement as both a primary and revision implant

Baring

Popat

Abdelwahab

et al. 2016

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

“…The UHR is a clinically proven means of re-establishing mechan ical contact between the distal radius and ulna to restore stability of the entire forearm [81,91,92]. The first UHR with previously performed Darrach or Sauvé-Kapandji procedures utilizing a metal head which articulates with a metal cup proximal to the sigmoid notch was introduced in 1992 by Kapandji, and followed by Herbert and van Schoonhoven using an UHR with a ceramic head they started with its use in 1995 [93,94].…”

Section: Discussionmentioning

confidence: 99%

Who introduced the "quadrangular-construct" modification of the Sauvé Kapandji procedure first? Case presentation and brief overview of literature with regard to general, specific and practicable aspects to primary trauma-related surgical treatment including possible salvage options at the distal radioulnar joint

Schmidt¹,

Schmitz²,

Muradyan³

et al. 2017

Trauma Emerg Care

View full text Add to dashboard Cite

A 26-year-old male sustained a left wrist injury after an occupational fall from height that was diagnosed as wrist sprain and treated conservatively by a plaster splint in another institution. Eight weeks after injury, the patient could be re-employed in his original occupation as a truck driver. Six years after injury, the patient came in our institution for the first time, and reported increasing pain in his left wrist accompanied with marked restriction of his left forearm's supination and pronation leading to the non-ability to carry out his occupational job 8 weeks previously. On clinical examination, there was pronounced dorsal subluxation of the ulnar head without any given possibilities for it manual closed reduction (i.e. static instability in transverse plane) ( Figure 1A). Posterior-anterior (PA) radiographs of both wrists showed no concomitant ulnar positiv variance (UPV) (i.e. no longitudinal instability) and no posttraumatic arthritic changes in the distal radioulnar joint (DRUJ), but the configuration of the ulnar styloid at the formerly injured left wrist could not be well assessed that suggested an additional rotation deformity of the ulnar head ( Figure 1B). Lateral radiographs of both wrist showed marked fixed subluxation of the ulnar head in dorsal direction (i.e. static instability in transverse plane) ( Figure 1C). Due to these findings, the Sauvé-Kapandji procedure, modified by creating a "quadrangularconstruct", was detected by us. At the preoperative radiographs of the left elbow in both planes there were no signs of any pre-existing degenerative changes with specific regard to the radiocapitellar joint.Intraoperatively, first, the 2 cm long ulna segment was excised typically proximal to the DRUJ, then a Kirschner-wire was drilled into the ulnar head parallel to the plane of the operation table on which the left forearm was positioned at terminal range of pronation (i.e. 90°) ( Figure 2A). After that, the ulnar head was rotated 90° perpendicular to the operation table's plane in dorsal direction using the formerly drilled Kirschner-wire, and so the neutral position of DRUJ could be achieved in which the arthrodesis had to be performed ( Figure 2B). Then, the cartilage of both corresponding surfaces in DRUJ was excised, and the DRUJ arthrodesis in neutral position was carried out using a 3.5 mm titanium malleolar screw, and the Kirschner-wire was removed. The next step included the several years later introduced "quadrangularconstruct" modification of the original Sauvé-Kapandji procedure: After decorticalization of the corresponding radius and ulna shafts proximal to the DRUJ arthrodesis and distal to resection plane of the ulna segment, the formerly excised ulna segment has been inserted transversely between both forearm bones and fixated with a second 3.5 mm titanium cortical screw through the ulna segment graft, and finally, complete restoration of rotation motion arc could be achieved ( Figures 2C-D). The correctly performed surgical procedure was confirmed intraoperatively by flu...

show abstract

Distal Radial–Ulnar Joint

Suh

2021

Evidence‐Based Orthopedics

View full text Add to dashboard Cite

Functional and Radiographic Outcomes Following Distal Ulna Implant Arthroplasty

Cited by 60 publications

References 32 publications

Short- to mid-term results of ulna head replacement as both a primary and revision implant

Short- to mid-term results of ulna head replacement as both a primary and revision implant

Distal Radial–Ulnar Joint

Contact Info

Product

Resources

About