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Martínez Villén G, Espada Blasco C, Rodríguez Nogué L, García González E. Long-term results of the Aptis TM total distal radioulnar joint prosthesis after previous failed surgical procedures. J Hand Surg Eur Vol 2024; 49:82-90. [PMID: 37747488 DOI: 10.1177/17531934231192375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
We present a prospective study with the results of ten Aptis total distal radioulnar joint replacements in patients who had one to five previous operations. The mean postoperative follow-up was 9.7 years (range 3-14.7). The mean postoperative range of motion of the wrist improved by 9° for extension, 15° for flexion, 10° for pronation and 14° for supination, achieving values equivalent to 88%, 78%, 97% and 88% of those of the non-operated hand. There were minimal changes in radial and ulnar deviations. Grip strength improved by 7 kg, pain decreased by 8 points, QuickDASH and Mayo wrist scores improved by 51 and 53 points, respectively. Two implants had radiolucency less than 1 mm. Serum titanium ion levels were slightly elevated in two patients. Three prostheses required revision surgery for heterotopic ossification, a prominent radial screw and a periprosthetic fracture. No prostheses were removed. Six patients returned to their former professional activities and four patients adapted their jobs.Level of evidence: IV.
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Affiliation(s)
- Gregorio Martínez Villén
- Department of Orthopaedic and Traumatology (Hand and Reconstructive Surgery Unit), Miguel Servet University Hospital, Zaragoza, Spain
| | - Carlos Espada Blasco
- Department of Orthopaedic and Traumatology (Hand and Reconstructive Surgery Unit), Miguel Servet University Hospital, Zaragoza, Spain
| | - Luis Rodríguez Nogué
- Department of Orthopaedic and Traumatology, University Hospital Royo Villanova, Zaragoza, Spain
| | - Elena García González
- Department of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain
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Huang Y, Yang Q, Wang Z, Pan Z, Zhang Y, Shi Z, Yang S. Comparisons of in-hospital complications between total hip arthroplasty and hip resurfacing arthroplasty. BMC Musculoskelet Disord 2023; 24:375. [PMID: 37170240 PMCID: PMC10173641 DOI: 10.1186/s12891-023-06487-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/03/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Hip resurfacing arthroplasty (HRA) is a less common but effective alternative method to total hip arthroplasty (THA) for hip reconstruction. In this study, we investigated the incidences of in-hospital complications between patients who had been subjected to THA and HRA. METHODS The National Inpatient Sample data that had been recorded from 2005 to 2014 was used in this study. Based on the International Classification of Disease, Ninth Revision, Clinical Modification, patients who underwent THA or HRA were included. Data on demographics, preoperative comorbidities, length of hospital stay, total charges, and in-hospital mortality and complications were compared. Multiple logistic regression analysis was used to determine whether different surgical options are independent risk factors for postoperative complications. RESULTS A total of 537,506 THAs and 9,744 HRAs were obtained from the NIS database. Patients who had been subjected to HRA exhibited less preoperative comorbidity rates, shorter length of stay and extra hospital charges. Moreover, HRA was associated with more in-hospital prosthesis loosening. Notably, patients who underwent HRA were younger and presented less preoperative comorbidities but did not show lower incidences in most complications. CONCLUSIONS The popularity of HRA gradually reduced from the year 2005 to 2014. Patients who underwent HRA were more likely to be younger, male, have less comorbidities and spend more money on medical costs. The risk of in-hospital prosthesis loosening after HRA was higher. The HRA-associated advantages with regards to most in-hospital complications were not markedly different from those of THA. In-hospital complications of HRA deserve more attention from surgeons.
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Affiliation(s)
- Yuanyuan Huang
- School of Health, Dongguan Polytechnic, Dongguan, Guangdong, 523000, China
| | - Qinfeng Yang
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, Guangdong, 510515, China
| | - Ziqi Wang
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, Guangdong, 510515, China
| | - Zhijie Pan
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, Guangdong, 510515, China
| | - Yang Zhang
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, Guangdong, 510515, China.
| | - Zhanjun Shi
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, Guangdong, 510515, China.
| | - Sheng Yang
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, Guangdong, 510515, China.
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
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McBryde CW, Prakash R, Haddad FS. Hip resurfacing. Bone Joint J 2023; 105-B:467-470. [PMID: 37121587 DOI: 10.1302/0301-620x.105b5.bjj-2023-0015.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Callum W McBryde
- Young Adult Hip Unit, Royal Orthopaedic Hospital, Birmingham, UK
| | - Rohan Prakash
- Young Adult Hip Unit, Royal Orthopaedic Hospital, Birmingham, UK
| | - Fares S Haddad
- Department of Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK
- The Bone & Joint Journal , London, UK
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Palazzuolo M, Bensa A, Bauer S, Blakeney WG, Filardo G, Riegger M. Resurfacing Hip Arthroplasty Is a Safe and Effective Alternative to Total Hip Arthroplasty in Young Patients: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12062093. [PMID: 36983096 PMCID: PMC10052473 DOI: 10.3390/jcm12062093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/30/2023] Open
Abstract
This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed at comparing resurfacing hip arthroplasty (RHA) and total hip arthroplasty (THA) in terms of rate of complications, revisions, functional outcomes, blood loss, operative time and metal ions levels. The search was conducted on three databases (PubMed, Cochrane and Web of Science) updated until 13 October 2022. The inclusion criteria were RCTs) written in the English language, with no time limitation, comparing RHA and THA. Among the retrieved 4748 articles, 18 RCTs were eligible for a total of 776 patients (mean age 53.1 ± 5.0). A meta-analysis was performed. RHA reported significantly lower blood loss compared to THA (p < 0.001) but with longer operative time (p < 0.001). No statistically significant difference was found between RHA and THA in terms of complications (12.08% and 16.24%, respectively) and revisions (6.32% and 6.14%, respectively). Both RHA and THA provide excellent clinical results in a population of young and active patients. Functional outcomes were not significantly different between the groups. Moreover, no significant difference in metal ion levels was found. These findings provide evidence concerning the safety and clinical effectiveness of RHA. Because of its bone-preserving properties, the lack of drawbacks and good outcomes, RHA appears to be a valid alternative to THA in young and active patients.
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Affiliation(s)
- Michele Palazzuolo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6600 Locarno, Switzerland
| | - Alessandro Bensa
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland
| | - Stefan Bauer
- Service d'Orthopédie et de Traumatologie, Chirurgie de l'Épaule, Ensemble Hospitalier de la Côte, 1110 Morges, Switzerland
- Department of Orthopedic Surgery, Royal Perth Hospital, Perth, WA 6000, Australia
| | - William G Blakeney
- Department of Orthopedic Surgery, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Martin Riegger
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
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Martínez Villén G, Rodríguez Nogué L, García González E. Postoperative assessment and management of metallosis and periprosthetic osteolysis in patients treated with metal-on-polyethylene total wrist prostheses. J Hand Surg Eur Vol 2022; 47:952-958. [PMID: 35866419 DOI: 10.1177/17531934221113723] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We analysed the relationship between serum metal ions, radiological periprosthetic osteolysis and the clinical features in a series of 25 patients treated with fourth-generation metal-on-polyethylene total wrist prostheses. The mean implant follow-up was 7 years. Our results show that titanium was the main elevated serum metal ion in patients with the prostheses that we used; elevated serum cobalt or chromium values were infrequent. The risk of loosening was higher in an implant older than 6 years, with more than five periprosthetic osteolysis points according to our radiograph zone system, and serum titanium values between 26 to 31 µg/L. The presence of metallosis pseudotumours does not guarantee but increases the risk of implant failure, which may be asymptomatic or associated with little pain.Level of evidence: IV.
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Affiliation(s)
- Gregorio Martínez Villén
- Department of Orthopaedic and Traumatology (Hand and Reconstructive Surgery Unit), Miguel Servet University Hospital, Zaragoza, Spain
| | - Luis Rodríguez Nogué
- Department of Orthopaedic and Traumatology (Hand and Reconstructive Surgery Unit), Miguel Servet University Hospital, Zaragoza, Spain
| | - Elena García González
- Department of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain
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