Daniel Reiser MD, PhD , Per Fischer MD, PhD , Kurt Pettersson MD, PhD , Per Wretenberg MD, PhD , Marcus Sagerfors MD, PhD
{"title":"新设计全腕关节置换术20例,随访8年。","authors":"Daniel Reiser MD, PhD , Per Fischer MD, PhD , Kurt Pettersson MD, PhD , Per Wretenberg MD, PhD , Marcus Sagerfors MD, PhD","doi":"10.1016/j.jhsa.2023.08.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Total wrist arthroplasty (TWA) is an established motion-preserving alternative to arthrodesis in the treatment of wrist arthritis, but post-TWA complications requiring additional surgery remain an issue. A new TWA design has been proposed. The purpose of this study was to report the outcome of a cohort study of 20 patients who underwent surgery using the new TWA design.</div></div><div><h3>Methods</h3><div>Patients were assessed before surgery and at 1, 2, and 8 years after surgery for visual analog scale (VAS) pain scores, wrist range of motion, hand grip strength, and patient-reported outcome measures (PROMs). Radiographic examination was conducted for evidence of prosthetic loosening. Reasons for revision were analyzed.</div></div><div><h3>Results</h3><div>In total, 24 reoperations were performed, including 12 revisions in 6 patients. Patient-reported outcome measures improved significantly at the 2-year follow-up compared with preoperative values. Hand grip strength, wrist extension, and VAS pain scores improved significantly at the 2-year follow-up. No radiographic loosening of the components was observed, but backing out of the carpal screws was noted in 16 of the 20 cases.</div></div><div><h3>Conclusions</h3><div>The new TWA resulted in improved VAS pain scores, PROMs, wrist extension, and hand grip strength. The high frequency of reoperation is a concern, and modification of the implant is needed.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 3","pages":"Pages 377.e1-377.e8"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Total Wrist Arthroplasty With a New Design: 20 Cases With 8-Year Follow-Up\",\"authors\":\"Daniel Reiser MD, PhD , Per Fischer MD, PhD , Kurt Pettersson MD, PhD , Per Wretenberg MD, PhD , Marcus Sagerfors MD, PhD\",\"doi\":\"10.1016/j.jhsa.2023.08.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>Total wrist arthroplasty (TWA) is an established motion-preserving alternative to arthrodesis in the treatment of wrist arthritis, but post-TWA complications requiring additional surgery remain an issue. A new TWA design has been proposed. The purpose of this study was to report the outcome of a cohort study of 20 patients who underwent surgery using the new TWA design.</div></div><div><h3>Methods</h3><div>Patients were assessed before surgery and at 1, 2, and 8 years after surgery for visual analog scale (VAS) pain scores, wrist range of motion, hand grip strength, and patient-reported outcome measures (PROMs). Radiographic examination was conducted for evidence of prosthetic loosening. Reasons for revision were analyzed.</div></div><div><h3>Results</h3><div>In total, 24 reoperations were performed, including 12 revisions in 6 patients. Patient-reported outcome measures improved significantly at the 2-year follow-up compared with preoperative values. Hand grip strength, wrist extension, and VAS pain scores improved significantly at the 2-year follow-up. No radiographic loosening of the components was observed, but backing out of the carpal screws was noted in 16 of the 20 cases.</div></div><div><h3>Conclusions</h3><div>The new TWA resulted in improved VAS pain scores, PROMs, wrist extension, and hand grip strength. The high frequency of reoperation is a concern, and modification of the implant is needed.</div></div><div><h3>Type of study/level of evidence</h3><div>Therapeutic IV.</div></div>\",\"PeriodicalId\":54815,\"journal\":{\"name\":\"Journal of Hand Surgery-American Volume\",\"volume\":\"50 3\",\"pages\":\"Pages 377.e1-377.e8\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hand Surgery-American Volume\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S036350232300446X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand Surgery-American Volume","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S036350232300446X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Total Wrist Arthroplasty With a New Design: 20 Cases With 8-Year Follow-Up
Purpose
Total wrist arthroplasty (TWA) is an established motion-preserving alternative to arthrodesis in the treatment of wrist arthritis, but post-TWA complications requiring additional surgery remain an issue. A new TWA design has been proposed. The purpose of this study was to report the outcome of a cohort study of 20 patients who underwent surgery using the new TWA design.
Methods
Patients were assessed before surgery and at 1, 2, and 8 years after surgery for visual analog scale (VAS) pain scores, wrist range of motion, hand grip strength, and patient-reported outcome measures (PROMs). Radiographic examination was conducted for evidence of prosthetic loosening. Reasons for revision were analyzed.
Results
In total, 24 reoperations were performed, including 12 revisions in 6 patients. Patient-reported outcome measures improved significantly at the 2-year follow-up compared with preoperative values. Hand grip strength, wrist extension, and VAS pain scores improved significantly at the 2-year follow-up. No radiographic loosening of the components was observed, but backing out of the carpal screws was noted in 16 of the 20 cases.
Conclusions
The new TWA resulted in improved VAS pain scores, PROMs, wrist extension, and hand grip strength. The high frequency of reoperation is a concern, and modification of the implant is needed.
期刊介绍:
The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.