Re-motion total wrist arthroplasty: 39 non-rheumatoid cases with a mean follow-up of 7 years

Froschauer, Stefan M.; Zaussinger, Maximilian; Hager, Dietmar; Behawy, Manfred; Kwasny, O.; Duscher, Dominik

doi:10.1177/1753193419866117

Cited by 19 publications

(24 citation statements)

References 12 publications

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“…Recently, some authors have extended the range of indications for TWA to non-rheumatoid conditions and compared their results to rheumatoid arthritis [ 4 , 5 , 6 ]. The present study and the previously published study [ 7 ] are the first ones to solely present outcomes of non-rheumatoid patients.…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective review identified all patients who underwent TWA between July 2007 and February 2018 at a single institution. Compared to our previous study [ 7 ], we have extended the review period to identify all patients with a theoretical follow-up period of a minimum of 24 months. In this period, two level IV surgeons [ 8 ] performed TWA using CCR according to the manufacturer‘s surgical technique [ 1 ].…”

Section: Methodsmentioning

confidence: 99%

“…Besides the discussion regarding proper indications for TWA based on different patients’ primary condition, age, bone stock, and activity levels, the present study aims to examine an alternative surgical technique for ReMotion TWA. The rationale for this approach was the fact that we have observed radial impaction syndrome as the most frequent postoperative complication in our previous study [ 7 ]. This represents an impingement between the prosthesis’s radial socket and the scaphoid.…”

Section: Introductionmentioning

confidence: 99%

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Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

Froschauer

Holzbauer

Hager³

et al. 2021

JCM

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High complication rates in total wrist arthroplasty (TWA) still lead to controversy in the medical literature, and novel methods for complication reduction are warranted. In the present retrospective cohort study, we compare the outcomes of the proximal row carpectomy (PRC) method including total scaphoidectomy (n = 22) to the manufacturer’s conventional carpal resection (CCR) technique, which retains the distal pole of the scaphoid (n = 25), for ReMotion prosthesis implantation in non-rheumatoid patients. Mean follow-up was 65.8 ± 19.8 and 80.0 ± 28.7 months, respectively. Pre- and postoperative clinical assessment included wrist flexion-extension and radial-ulnar deviation; Disability of Arm, Shoulder, and Hand scores; and pain via visual analogue scale. At final follow-up, grip strength and satisfaction were evaluated. All complications, re-operations, and revision surgeries were noted. Clinical complications were significantly lower in the PRC group (p = 0.010). Radial impaction was detected as the most frequent complication in the CCR group (n = 10), while no PRC patients suffered from this complication (p = 0.0008). Clinical assessment, grip strength measurements, and the log rank test evaluating the re-operation as well as revision function showed no significant difference. All functional parameters significantly improved compared to preoperative values in both cohorts. In conclusion, we strongly recommend PRC for ReMotion prosthesis implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

Froschauer

Holzbauer

Hager³

et al. 2021

JCM

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“…Ebenfalls für die Universal2Prothese (Integra Life Sciences) haben Brinkhorst et al 2017 [33] [39] operierten mit diesem Implantat dagegen ausschließlich posttraumatische Fälle (n = 39) und fanden nach durchschnittlich 7 Jahren immerhin 13 Komplika tionen von denen aber in 5 Fällen ein Impingement zwischen der radialen Prothesenkomponente und dem Skaphoid, welches durch ein ausreichendes intraoperatives skaphoidales Trimming hätte vermieden werden können. Immerhin musste nach 7 Jahren nur eine von 39 Prothesen gewechselt werden.…”

Section: Hemiprothesenunclassified

Die Endoprothetik des Handgelenkes

Arnold¹

2020

Arthritis und Rheuma

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ZUSAMMENFASSUNGIn der Vergangenheit wurde der endoprothetische Ersatz des Handgelenkes nahezu ausschließlich bei älteren, „low-demand“ Patienten und bestehender rheumatoider Arthritis durchgeführt. Ein jüngeres Lebensalter, insbesondere im Zusammenhang mit einer posttraumatischen Arthrose gilt z. T. immer noch als Kontraindikation. Dieses Dogma hat sich inzwischen mit den guten mittelfristigen Erfahrungen im Umgang mit der 4. Prothesengeneration deutlich geändert. Für die derzeit verfügbaren Implantate werden Standzeiten von 86 % nach 10 Jahren (Motec) 1, 78 % über 15 Jahre (Universal 2) 2, oder 94 % für 8 Jahre (ReMotion) berichtet 3. Hierbei ließen sich auch für die vermeintlich schwierigere Klientel der Jüngeren ein zuverlässiger Erhalt eines für die täglichen Dinge ausreichenden Bewegungsumfanges, eine zuverlässige Schmerzbefreiung und ein Zugewinn für die Griffstärke darstellen. Alternativ garantiert auch die Arthrodese des Handgelenkes keineswegs immer eine hohe Patientenzufriedenheit und niedrige Komplikationsrate. Dennoch reichen die bisherigen Publikationen, insbesondere aufgrund ihrer geringen Fallstärke, weiterhin nicht aus, um den künstlichen Handgelenkersatz über die Anwendung in wenigen Spezialzentren hinaus generell empfehlen zu können. Weiterhin lässt sich nicht beantworten, warum diesbezüglich die OP-Frequenz im Widerspruch zu den deutlich verbesserten Ergebnissen eher wieder abzunehmen scheint 4.

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“…Total wrist arthroplasty (TWA) has a history as long as total knee and hip joint replacements 1 ; however, it has not demonstrated the same high survival rates 2‐4 . Although current TWA designs 5‐8 have improved over the past decade and have started to become a reliable option for some patients, 6 high complication rates are still a major issue 9‐11 . While the reasons for the complications following a TWA are debated, studies evaluating total joint replacements of the knee, shoulder, spine, and hip have shown that kinematic differences between the healthy and replaced joint motion can lead to implant and bone‐implant interface failures 12‐16 .…”

Section: Introductionmentioning

confidence: 99%

Proximal‐distal shift of the center of rotation in a total wrist arthroplasty is more than twice of the healthy wrist

Akhbari

Morton

Shah

et al. 2020

Journal Orthopaedic Research

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Reproduction of healthy wrist biomechanics should minimize the abnormal joint forces that could potentially result in the failure of a total wrist arthroplasty (TWA). To date, the in vivo kinematics of TWA have not been measured and it is unknown if TWA preserves healthy wrist kinematics. Therefore, the purpose of this in vivo study was to determine the center of rotation (COR) for a current TWA design and to compare its location to the healthy wrist. The wrist COR for six patients with TWA and 10 healthy subjects were calculated using biplane videoradiography as the subjects performed various range‐of‐motion and functional tasks that included coupled wrist motions. An open‐source registration software, Autoscoper, was used for model‐based tracking and kinematics analysis. It was demonstrated that the COR was located near the centers of curvatures of the carpal component for the anatomical motions of flexion‐extension and radial‐ulnar deviation. When compared to healthy wrists, the COR of TWAs was located more distal in both pure radial deviation (P < .0001) and pure ulnar deviation (P = .07), while there was no difference in its location in pure flexion or extension (P = .99). Across all coupled motions, the TWA's COR shifted more than two times that of the healthy wrists in the proximal‐distal direction (17.1 vs 7.2 mm). We postulate that the mismatch in the COR location and behavior may be associated with increased loading of the TWA components, leading to an increase in the risk of component and/or interface failure.

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Re-motion total wrist arthroplasty: 39 non-rheumatoid cases with a mean follow-up of 7 years

Cited by 19 publications

References 12 publications

Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

Die Endoprothetik des Handgelenkes

Proximal‐distal shift of the center of rotation in a total wrist arthroplasty is more than twice of the healthy wrist

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