Pseudotumour secondary to metallosis following total wrist arthroplasty

Taha,, R.; Roushdi, I. M.; Williams, Craig D.

doi:10.1177/1753193415594110

Cited by 14 publications

(19 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The radial screw may cross the second CMCJ into the second metacarpal for added fixation; however, the ulnar screw should not cross the fourth CMCJ due to potential generation of pain secondary to joint mobility. 8 Some authors recommend crossing the fourth CMCJ if added fixation is needed, but we have not found this to be successful. In salvage care, if planning to cross the fourth CMCJ, the joint should be prepared for arthrodesis.…”

Section: Discussionmentioning

confidence: 65%

“…If implant arthroplasty is chosen, metal wear can be prevented by ensuring no contact between the ulna head arthroplasty and radial component in all positions. 8,11 No literature consensus exists between simple radial head resection and implant arthroplasty; however, hemiresection is not recommended with instability due to risk of impingement between the ulna and radius. 3…”

Section: Discussionmentioning

confidence: 99%

“…Revision of TWA due to aseptic loosening may require bone grafting and augmented fixation; this can be achieved with allograft bone as supported by the literature. 7,8,11 If the fixation remains tenuous after bone grafting, wrist arthrodesis is a better option. Preoperative TWA counseling should include understanding of possible wrist arthrodesis, with success after TWA explant being lower than primary wrist arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative TWA counseling should include understanding of possible wrist arthrodesis, with success after TWA explant being lower than primary wrist arthrodesis. 7,8,18…”

Section: Discussionmentioning

confidence: 99%

“…4 Possible complications include carpal tunnel syndrome (CTS), ulnar head impingement, loosening of the components, screw breakage, screw penetration of fourth/fifth carpometacarpal joint (CMCJ), infection, periprosthetic fracture, dislocation, and metallosis. 2,5-8 We present a case of revision TWA, which highlights preventable complications with review of the literature and discussion of histopathogenesis, diagnosis, and treatment.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Revision Total Wrist Arthroplasty Due to Polyethylene Wear, Metallosis-Induced Carpal Tunnel Syndrome, Distal Ulnar Impingement, and Fourth Carpometacarpal Joint Pain: Case Report and Pitfalls to Avoid

Nuñez

Wright

Kilpatrick

et al. 2018

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background: Total wrist arthroplasty (TWA) is indicated to alleviate pain secondary to arthritis while preserving wrist motion. Despite vigilant measures, TWAs are susceptible to complications. The current case illustrates an array of preventable complications which are addressed through operative technique in a revision setting. Case presentation: The patient was a 72-year-old man who presented with chronic pain at the fourth carpometacarpal joint (CMCJ) and distal radioulnar joint with paresthesias in the median nerve distribution. Surgery was undertaken to address the following complications secondary to a previous TWA: impingement of the native distal ulna on the prosthesis, carpal tunnel due to metallosis and polyethylene synovitis, loose carpal component, and prominent screw at the fourth CMCJ. Surgical correction included open carpal tunnel release with extensive flexor tenosynovectomy, distal ulna resection and implant arthroplasty with shortening, revision of carpal component with bone grafting, and shortening of the ulnar screw to avoid crossing the fourth CMCJ. Within 6 months of the procedure, the patient reported resolution of neuropathic symptoms and pain-free motion of the wrist. Discussion: Preventable complications associated with TWA are individually highlighted. In addition, we compare and contrast our approach and surgical technique to current reported literature. Overall, we provide education and guidance to avoid possible TWA pitfalls. Conclusion: With this case report, we hope to increase TWA knowledge with emphasis on the requirements of judicious patient selection, preoperative planning, meticulous surgical technique, and complication awareness for subsequent optimization of wrist function, stability, and durability.

show abstract

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Preoperative TWA counseling should include understanding of possible wrist arthrodesis, with success after TWA explant being lower than primary wrist arthrodesis. 7,8,18…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Revision Total Wrist Arthroplasty Due to Polyethylene Wear, Metallosis-Induced Carpal Tunnel Syndrome, Distal Ulnar Impingement, and Fourth Carpometacarpal Joint Pain: Case Report and Pitfalls to Avoid

Nuñez

Wright

Kilpatrick

et al. 2018

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

Arthroplasty of the Hand and Wrist

Jacob

2018

Arthroplasty for the Treatment of Fractures in the Older Patient

View full text Add to dashboard Cite

Metallosis in shoulder arthroplasty: an integrative review of literature

et al. 2016

View full text Add to dashboard Cite

Shoulder arthroplasty has gained popularity as an efficient means of achieving pain relief and improved function in a variety of complex shoulder disorders. Despite promising reports, given the increasing number of shoulder arthroplasty procedures, various causes that may contribute to failure of a well-functioning arthroplasty are being increasingly recognized. One such disastrous condition is metallosis, a subject which has not been much talked off with reference to shoulder arthroplasty. This article besides reviewing the existing literature intends to discuss the possible causes that contribute to metallosis and devise a protocol for its timely diagnosis and management.

show abstract

Pseudotumour secondary to metallosis following total wrist arthroplasty

Abstract: Figure 1. X-ray and magnetic resonance imaging proton density with gadolinium appearances of the pseudotumour.

Cited by 14 publications

References 4 publications

Revision Total Wrist Arthroplasty Due to Polyethylene Wear, Metallosis-Induced Carpal Tunnel Syndrome, Distal Ulnar Impingement, and Fourth Carpometacarpal Joint Pain: Case Report and Pitfalls to Avoid

Revision Total Wrist Arthroplasty Due to Polyethylene Wear, Metallosis-Induced Carpal Tunnel Syndrome, Distal Ulnar Impingement, and Fourth Carpometacarpal Joint Pain: Case Report and Pitfalls to Avoid

Arthroplasty of the Hand and Wrist

Metallosis in shoulder arthroplasty: an integrative review of literature

Contact Info

Product

Resources

About