Kinematic analysis of forearm rotation using four-dimensional computed tomography

Oonk, Joris G M; Dobbe, Johannes G. G.; Strijkers, Gustav J.; Rijn, Sybren K van; Streekstra, Geert J.

doi:10.1177/17531934221142520

Cited by 11 publications

(10 citation statements)

References 34 publications

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“…2A ). Possible explanations for the aseptic loosening could be altered DRUJ geometry and a displacement of the forearm rotation axis 4 17 most likely resulting in a deviation of the radius toward the ulna causing extreme friction forces ( Fig. 2B ).…”

Section: Resultsmentioning

confidence: 99%

Aptis Distal Radioulnar Joint Implant: Management of Remarkable Complications

Stougie,

Kemme,

Coert

et al. 2024

J Wrist Surg

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Background The aim of an Aptis distal radioulnar joint (DRUJ) implant is to reconstruct the DRUJ in patients with a destroyed, painful DRUJ, and gross ulnar instability. The literature is scarce regarding the management of (severe) early complications related to the Aptis implant in wrists with more rare conditions, such as rheumatoid arthritis, congenital malformations, or leiomyosarcoma of the distal ulna. Purpose This paper describes the clinical results, (severe) early complications related to the implant, revision surgery, patient satisfaction with the revision surgery, and esthetic appearance of the affected wrist in this specific cohort. Patients and Methods Retrospective evaluation of five consecutive patients with a short-to-medium follow-up time of 32 months (range: 18–53 months) was carried out. Results The follow-up revealed implant osseointegration failure in two cases, periprosthetic fractures in two cases, and acute carpal tunnel syndrome in one case. Three Aptis DRUJ arthroplasties were converted into a proximal Darrach. In four cases (80%), the patient was satisfied with the revision surgery due to pain reduction. In four cases (80%), the esthetic appearance of the affected wrist was found disappointing. Conclusion This study describes remarkable complications related to the Aptis implants in wrists with more rare conditions. The implant is more likely to fail in wrists with poor bone stock, remodeling of the radius, deformation, and malformation of the radius. The range of indications for the usage of the implant to maintain wrist function may be strict. Level of Evidence IV.

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Section: Resultsmentioning

confidence: 99%

Aptis Distal Radioulnar Joint Implant: Management of Remarkable Complications

Stougie,

Kemme,

Coert

et al. 2024

J Wrist Surg

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“…Ideally, no collision should occur when the rotation angle ranges from -90° to 90°. The rotation axis is defined as the connecting line between the midpoints of the radial and ulnar heads 20 . Several cross-sections are established perpendicular to the rotation axis (Fig.…”

Section: Validation Methodsmentioning

confidence: 99%

Automatic Osteotomy Preoperative Planning for Forearm with Congenital Radioulnar Synostosis: A Dual Hierarchical Optimization Strategy

Zhou,

Cui,

Guo

et al. 2024

Preprint

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Congenital radioulnar synostosis (CRUS) presents a complex forearm deformity, requiring precise osteotomy planning for anatomical restoration. This study proposes an automatic osteotomy preoperative planning method for forearms with CRUS. Proximal forearm bones are first aligned with the template forearm and then a dual hierarchical optimization (DHO) strategy is used to optimize the spatial transformation parameters of the distal fragment. The subsequent optimization aims to maximize the overlap of cross-sections between proximal and distal fragments. Rotational simulations are ultimately conducted to predict postoperative forearm rotational functionality. The DHO strategy effectively restores ideal forearm morphology, with maximum deviations of 1.66 and 2.13 mm for the ulna and radius, respectively. The deformity angles of forearm bones are reduced to 1.35°, 1.39°, 4.83°, 1.20°, 1.03°, and 8.56°. Rotation function analysis reveals a noticeable improvement in achievable rotation range compared to plans by senior surgeons. Automated mobilization osteotomy planning, using the DHO strategy, shows potential for individualized CRUS corrective surgery, offering comprehensive and precise preoperative guidance.

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“…Common complications reported are periprosthetic fracture, pisotriquetral arthritis [ 16 ], infection [ 17 ], periprosthetic extensor tendon, and extensor compartment problems [ 10 , 13 , 15 ]. Complications with periprosthetic extensor tendons and compartments may be explained by the malpositioning of the radial component of the implant in the distal region, which alters the kinematic axis of forearm rotation [ 20 ]. This may also be caused by the deformation of the distal radius.…”

Section: Introductionmentioning

confidence: 99%

Performance of the Aptis Distal Radioulnar Joint Implant: A Clinical Case Series Including Four-Dimensional Computed Tomography Kinematic Analysis

Stougie,

van Doesburg,

Oonk

et al. 2023

JCM

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High complication rates and surgical revision rates following Aptis implant placement have been reported in the literature. This study evaluates the performance of the Aptis implant of twelve patients using four-dimensional kinematic analysis. The (mean) follow-up was 58 months. Wrist motion, grip strength, and kinematic analysis of both arms were used to investigate possible causes of the reported complications. In nine cases (75%), the proximal to distal translation of the distal radius along the ulnar axis in the affected forearm was too little or absent. Significant correlations were found between postoperative extension and translation of the distal radius along the ulnar axis and between the radial deviation and combined error. The four-dimensional kinematic analysis suggests that the current design of the implant could lead to limited restoration of the position of the forearm rotation axis and the translation of the radius along the ulnar axis.

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Kinematic analysis of forearm rotation using four-dimensional computed tomography

Cited by 11 publications

References 34 publications

Aptis Distal Radioulnar Joint Implant: Management of Remarkable Complications

Aptis Distal Radioulnar Joint Implant: Management of Remarkable Complications

Automatic Osteotomy Preoperative Planning for Forearm with Congenital Radioulnar Synostosis: A Dual Hierarchical Optimization Strategy

Performance of the Aptis Distal Radioulnar Joint Implant: A Clinical Case Series Including Four-Dimensional Computed Tomography Kinematic Analysis

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