Novel approach for posttraumatic panarthritis of the wrist using a pyrocarbon interposition arthroplasty (Amandys®): Preliminary series of 11 patients

Pierrart, J.; Bourgade, Paul; Mamane, W.; Rousselon, T.; Masméjean, E.

doi:10.1016/j.main.2012.07.011

Cited by 23 publications

(12 citation statements)

References 32 publications

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“…Two implants, however, had been converted to an arthrodesis for persistent pain with one further case of loosening at five years. In studies using pyrocarbon interpositional replacement there was high satisfaction (Bellemere et al, 2012; Daruwalla et al, 2012; Pierrart et al, 2012) but no significant improvement in motion before and after surgery. In our series, we could not present the preoperative data and the method of assessment was unique and not performed before surgery.…”

Section: Discussionmentioning

confidence: 98%

Dynamic assessment of the wrist after total wrist arthroplasty

Singh

Bhattacharjee

Dias

et al. 2017

J Hand Surg Eur Vol

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Our aim was to assess the outcome in patients with total wrist arthroplasty performed for end stage wrist osteoarthritis. We analysed the ranges of motion of operated and un-operated wrists using a flexible electrogoniometer during the Sollerman hand function test. We assessed grip strength with a digital dynamometer and completed patient reported outcome scores more than one year post-operatively. We reviewed 12 patients with a mean age of 64 (range 48-82) years. The flexion-extension arc was 72% and radioulnar deviation arc was 53% of the un-operated side but the total range of motion (area of circumduction) was 43% of the un-operated side and only 20% of the circumduction in age and gender-matched normal volunteers. Peak grip strength was 68% of the un-operated side. The patients reported good outcome with mean Michigan Hand Questionnaire (MHQ) scores of 56 (range 25-84) and mean Patient Evaluation Measure (PEM) scores of 39 (range 20-68). Patients completed the activities of Sollerman hand function test in twice the time (6 min) as required for a normal volunteer (2.8 min). The circumduction ellipses were narrow and central with limited radio-ulnar deviation and small mean areas of motion during activities of daily living.

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Section: Discussionmentioning

confidence: 98%

Dynamic assessment of the wrist after total wrist arthroplasty

Singh

Bhattacharjee

Dias

et al. 2017

J Hand Surg Eur Vol

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“…Capsuloligamentous laxity and cam effect are important elements to detect and assess during surgery for Amandys arthroplasty. Pierrart et al, 10 in a study of a series of 11 patients at 1-year of follow-up, also found the same causes of early failure. Table 8 Outcomes of TWA in published series with a minimum follow-up of 5 years and the present study Our study found no carpal misalignment because the operative indications were on the aligned wrist, especially in the anteroposterior axis.…”

Section: Discussionmentioning

confidence: 71%

“…Preliminary and short-term outcomes of Amandys were encouraging. [8][9][10] However, the mediumand long-term outcomes have not yet been reported.…”

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confidence: 99%

Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases

et al. 2021

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Background Amandys is a pyrocarbon interposition implant used as a therapeutic alternative to total wrist fusion (TWF) or total wrist arthroplasty (TWA) in painful and disabling extensive destruction of the wrist. Objective To review mid-term outcomes in a continuous prospective series of patients who underwent wrist arthroplasty Amandys with a minimum follow-up of 5 years. Methods Clinical evaluation included a satisfaction survey, pain, two functional scores, the short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the Patient-Rated Wrist Evaluation (PRWE), active wrist mobility, and grip strength compared with the contralateral side. Radiological evaluation was used to detect implant subsidence, carpal migration, bone lysis, or implant malposition. All per- and postoperative complications were collected. Results Fifty-nine patients (63 procedures) were evaluated with a mean follow-up of 7 years; 57% of the patients were males, and the mean age was 58 years. Among the patients, 90% were satisfied or very satisfied. Pain was significantly improved, with a gain of 4/10 (p < 0.001). Functional outcomes also improved between the second and fifth year of follow-up. Active mobility was preserved and grip strength was significantly improved by 7 kg (p < 0.001). No implant subsidence or carpal migration was observed. Ten patients (11.9%) underwent revision surgery for conflict (1%), rotation (6%), or implant dislocation (5%). All complications and revisions occurred early with no new events after 1 year of follow-up. Discussion Mid-term clinical and radiological outcomes were stable with improvement of functional scores. The survival rate was comparable to that reported for TWF with conserved mobility. We report fewer complications compared with those reported for TWA or TWF. Early instability of the implant was the main etiology of the revisions. Repositioning of the implant was successful. No conversion to TWA or TWF was necessary. Conclusions Mid-term outcomes of the Amandys implants were encouraging. Patients conserved good wrist motion with improved strength and functional scores. The implant was well tolerated. Functional outcomes continue to improve with the follow-up. The survival rate remains stable after 2 years. The level of evidence of this study is IV (therapeutic case series).

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“…A report from the Norwegian Arthroplasty register stated less favorable longevity of this implant, 0.77 at 4 years, but that figure was the subject of a later discussion, in which it was claimed that wrist implants had been underreported in the registry, thus skewing the figures. 20 A different concept is the Amandys pyrocarbon interposition arthroplasty, which was described by Bellemère et al 21 and by Pierrart et al, 22 reporting quite favorable results. In their series there are several posttraumatic cases, but the reports do not differentiate the results according to the diagnoses (rheumatoid arthritis, osteoarthritis, posttraumatic, and other), and follow-up time was very short.…”

Section: Discussionmentioning

confidence: 99%

Can Total Wrist Arthroplasty Be an Option in the Treatment of the Severely Destroyed Posttraumatic Wrist?

et al. 2013

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Total wrist arthroplasty (TWA) still remains a controversial procedure. Early types of implants have given disappointing results: The first generation were silicone implants whose risks included implant breakage, subsidence, and silicone synovitis.1-3 The next generation of implants required extensive bone resection, which had implications if Keywords► total wrist arthroplasty ► posttraumatic ► wrist arthritis ► wrist arthrosis ► prospective AbstractBackground Severely destroyed posttraumatic wrists are usually treated by partial or total wrist fusion or proximal row carpectomy. The indications for and longevity of total wrist arthroplasty (TWA) are still unclear. Case Description The aim of this study was to analyze a series in which one lastgeneration total wrist arthroplasty was used as a salvage procedure for wrists with severe arthritis due to traumatic causes. The data were prospectively recorded in a webbased registry. Seven centers participated. Thirty-five cases had a minimum follow-up time of 2 years. Average follow-up was 39 (24-96) months. Pain had improved significantly at follow-up, mobility remained unchanged. The total revision rate was 3.7%, and the implant survival was 92% at 4-8 years.Literature Review Very few studies have described specific results after TWA in posttraumatic cases and almost none using classical "third-generation" implants. The number of cases and the follow-up in the published series are small. Clinical Relevance Although painful posttraumatic wrists with severe joint destruction can be salvaged by partial or total fusion, we found that, evaluated at short-to midterm, total wrist arthroplasty can be an alternative procedure and gives results that are comparable to those obtained in rheumatoid cases. Level IV Case series

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Novel approach for posttraumatic panarthritis of the wrist using a pyrocarbon interposition arthroplasty (Amandys®): Preliminary series of 11 patients

Cited by 23 publications

References 32 publications

Dynamic assessment of the wrist after total wrist arthroplasty

Dynamic assessment of the wrist after total wrist arthroplasty

Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases

Can Total Wrist Arthroplasty Be an Option in the Treatment of the Severely Destroyed Posttraumatic Wrist?

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