【Touch®拇指腕表掌关节假体的短期疗效】。

IF 0.4 4区 医学 Q4 ORTHOPEDICS Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca Pub Date : 2023-08-15 DOI:10.55095/achot2023/033
D. Filus, R. Pavličný
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All of them suffered from stage II - IV osteoarthritis according to the Eaton-Littler classification. The range of motion - the opposition was assessed using the Kapandji score. The function and the pain were evaluated with the DASH questionnaire preoperatively and at 3 months, 6 months, 1 year and 2 years postoperatively. RESULTS After 24 months, 91.1% (51 patients) were satisfied with the surgical outcome. Altogether 8.9% of patients (5 patients) experienced postoperative exercise-induced pain, limitation of movement of the CMC joint or hand weakness. No dislocation or endoprosthetic loosening occurred in the evaluated group. Primary wound healing was reported in all patients and no superficial or deep infection was observed. The mean DASH score was 65.3 points preoperatively; at the 2-year follow-up, the mean score decreased to 10.8 points. The pain assessed in question 24 of the DASH questionnaire decreased from the mean value of 4.45 points to 1.2 points. 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引用次数: 0

摘要

Rhizarthrosis是拇指腕掌关节的一种退行性疾病,主要影响女性。一旦非手术治疗失败,就需要手术治疗。拇指-腕掌关节全关节成形术是外科治疗的选择之一。本研究旨在评估Touch®假体的短期功能和放射学结果,随访时间最短,即手术后两年。材料和方法本研究介绍了一组植入48名患者的56个内假体的结果。对双动Touch®假体进行了评估。该组由41名女性和7名男性组成,患者的中位年龄为62岁。在非手术治疗失败后,患者被要求进行手术。根据Eaton-Litler分类,所有患者均患有Ⅱ-Ⅳ期骨关节炎。运动范围-对手使用Kapandji评分进行评估。术前和术后3个月、6个月、1年和2年用DASH问卷评估功能和疼痛。结果术后24个月,91.1%(51例)患者对手术结果满意。8.9%的患者(5名患者)经历了术后运动引起的疼痛、CMC关节运动受限或手部无力。评估组未发生脱位或假体内松动。据报道,所有患者的伤口均已初步愈合,未观察到浅表或深部感染。术前DASH平均得分为65.3分;在2年的随访中,平均得分下降到10.8分。DASH问卷问题24中评估的疼痛从4.45分的平均值降至1.2分。根据Kapandji的说法,两年后,所有患者的运动范围均为X/X。讨论有很多外科技术可以治疗水刺。所有类型的手术都有其优点和缺点。目前使用的大多数内假体在短期、中期甚至长期生存方面都表现出良好的效果。Touch®假体具有双重灵活性,是第三代拇指CMC假体,在我们的研究中,其短期结果与国际文献报道的结果相当。双迁移率设计的使用似乎在降低位错率方面是有效的。结论Touch®拇指CMC假体具有很好的短期功能和放射学效果。我们可以建议患者在手术后随访两年以上。关键词:喉血栓、骨关节炎、腕掌关节内假体、双重灵活性、Touch®。
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[Short-term Outcomes of Touch® Prosthesis for Thumb Carpometacarpal Joint].
PURPOSE OF THE STUDY Rhizarthrosis, a degenerative condition of the carpometacarpal joint of the thumb, affects mainly women. Surgical treatment is indicated once the non-operative treatment fails. Thumb carpometacarpal joint total arthroplasty constitutes one of the surgical treatment options. This study aims to evaluate the short-term functional and radiological outcomes of Touch® prosthesis with a minimum follow-up period, namely two years after surgery. MATERIAL AND METHODS The study presents the outcomes of a group of 56 endoprostheses implanted in 48 patients. The dual mobility Touch® prosthesis is evaluated. The group consisted of 41 women and 7 men, with the median age of the patients being 62 years. The patients were indicated for surgery after the non-operative treatment had failed. All of them suffered from stage II - IV osteoarthritis according to the Eaton-Littler classification. The range of motion - the opposition was assessed using the Kapandji score. The function and the pain were evaluated with the DASH questionnaire preoperatively and at 3 months, 6 months, 1 year and 2 years postoperatively. RESULTS After 24 months, 91.1% (51 patients) were satisfied with the surgical outcome. Altogether 8.9% of patients (5 patients) experienced postoperative exercise-induced pain, limitation of movement of the CMC joint or hand weakness. No dislocation or endoprosthetic loosening occurred in the evaluated group. Primary wound healing was reported in all patients and no superficial or deep infection was observed. The mean DASH score was 65.3 points preoperatively; at the 2-year follow-up, the mean score decreased to 10.8 points. The pain assessed in question 24 of the DASH questionnaire decreased from the mean value of 4.45 points to 1.2 points. After two years, the range of motion of all patients was X/X according to Kapandji. DISCUSSION There are plenty of surgical techniques to manage rhizarthrosis. All types of surgery have their pros and cons. Most endoprostheses used nowadays show good short-term, mid-term, and some of them even long-term outcomes in terms of survival. The Touch® prosthesis, characterized by dual mobility, is the 3rd generation thumb CMC prosthesis and in our study achives comparable short-term outcomes to those reported by international literature. The use of the dual mobility design appears to be effective in reducing the dislocation rate. CONCLUSIONS The Touch® thumb CMC prosthesis achieves very good short-term functional and radiological outcomes. We can recommend the prosthesis provided the patients are followed-up for more than two years after surgery. Key words: rhizarthrosis, osteoarthritis, endoprosthesis of the carpometacarpal joint, dual mobility, Touch®.
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CiteScore
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25.00%
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期刊介绍: Editorial Board accepts for publication articles, reports from congresses, fellowships, book reviews, reports concerning activities of orthopaedic and other relating specialised societies, reports on anniversaries of outstanding personalities in orthopaedics and announcements of congresses and symposia being prepared. Articles include original papers, case reports and current concepts reviews and recently also instructional lectures.
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