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Reigstad O, Holm-Glad T, Korslund J, Myhre C, Thorkildsen R, Røkkum M. Long-Term Outcomes of Wrist Arthroplasty Using the ReMotion™ Implant in Non-inflammatory Wrist Pathology. J Hand Surg Asian Pac Vol 2024; 29:200-210. [PMID: 38726500 DOI: 10.1142/s2424835524500218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Background: Wrist arthroplasty is increasingly offered to patients with symptomatic wrist arthritis as an alternative to wrist arthrodesis. The purpose of this study was to present our outcomes with the ReMotion™ wrist arthroplasty in a consecutive series of patients with wrist arthritis from non-inflammatory conditions. Methods: Thirteen (eight women, nine dominant wrists) patients, 68 (44-85) years of age with advanced radiocarpal arthritis due to SLAC/SNAC (11) and Kienbock disease (2) had a ReMotion™ (Stryker, Michigan, USA) wrist arthroplasty implanted, and were prospectively followed for 7 (4-9) years. The outcome measures included patient-rated wrist and hand evaluation (PRWHE) score, disabilities of the arm, shoulder and hand questionnaire (QuickDASH) score, visual analogue pain score (0-10) on the radial and ulnar aspect of the wrist at rest (VASrR/VASuR) and activity (VASrA/VASuA), active wrist range of motion (AROM) including flexion, extension, ulnar and radial deviation, pronation and supination and grip and key-pinch strength measured preoperatively and at yearly follow-ups by independent hand therapists. Results: Six patients had ten re-operations during the follow-up including four revisions to a new arthroplasty. Four were considered loose at follow-up. A significant reduction in PRWHE (63 to 12), radial pain at activity (6 to 1) and increased pronation (85° v 90°) was observed. Conclusions: We found a high complication and reoperation rate, two out of 13 had no complications or reoperations. The ReMotion™ arthroplasty should be used with caution in non-inflammatory wrist patients and the patients followed closely. A high reoperation and revision rate can be expected, and surgeons familiar with revision arthroplasty procedures should perform the surgery. Level of Evidence: Level II (Therapeutic).
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Affiliation(s)
- Ole Reigstad
- Orthopaedic Department, Martina Hansens Hospital, Baerum, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trygve Holm-Glad
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johanne Korslund
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cathrine Myhre
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Rasmus Thorkildsen
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Magne Røkkum
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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2
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Joyce TJ, Kandemir G, Warwick D, Brown DJ. Investigation of the short-term in vivo performance of metal-on-carbon fibre reinforced poly ether ether ketone Motec wrists: an explant analysis. J Hand Surg Eur Vol 2024:17531934241249919. [PMID: 38780046 DOI: 10.1177/17531934241249919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Total wrist arthroplasty (TWA) aims to restore pain-free motion to diseased joints. One such TWA, the Motec, has demonstrated good results with acceptable complication rates. It has recently been suggested that the metal-on-carbon fibre reinforced poly ether ether ketone (Mo-CFR-PEEK) version of the Motec TWA be implanted instead of the metal-on-metal version. An explant analysis was undertaken on seven Motec Mo-CFR-PEEK TWAs, revised for a variety of reasons, after a mean time of 2 years in vivo. Compared to a new Motec implant, five of the explanted metal heads and three of the CFR-PEEK cups became smoother in vivo, suggesting self-polishing and negative skewness, indicating some material loss in vivo. Two explanted cups showed indentation marks on their rims and one of these was from component impingement with embedded metallic debris. In the short-term, the articulating surfaces of Motec Mo-CFR-PEEK TWAs did not show major damage.Level of evidence: IV.
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Affiliation(s)
- Thomas J Joyce
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
| | - Göksu Kandemir
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
| | | | - Daniel J Brown
- Faculty of Health and Life Science, University of Liverpool, Liverpool, UK
- Liverpool University Hospitals NHS FT, Liverpool, UK
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3
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Sagerfors M, Reiser D. Massive Osteolysis and Pseudotumor Formation following Maestro Total Wrist Arthroplasty. Case Rep Orthop 2024; 2024:1301778. [PMID: 38469075 PMCID: PMC10927346 DOI: 10.1155/2024/1301778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/27/2023] [Accepted: 02/21/2024] [Indexed: 03/13/2024] Open
Abstract
Metallosis is a known complication of arthroplasty and has been reported for the hip, knee, and shoulder joints. Metallosis pseudotumors have been linked to an increased risk of implant failure. We report a case of pseudotumor with massive bone loss following total wrist arthroplasty (TWA) using the Maestro implant. Revision to arthrodesis is possible, but issues with bone loss have to be addressed. We recommend caution in offering TWA to young patients with high functional demands.
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Affiliation(s)
- Marcus Sagerfors
- Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, Sweden
| | - Daniel Reiser
- Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, Sweden
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4
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Boeckstyns MEH, Herzberg G. Complications after total wrist arthroplasty. J Hand Surg Eur Vol 2024; 49:177-187. [PMID: 38315136 DOI: 10.1177/17531934231203297] [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: 02/07/2024]
Abstract
We reviewed the incidence and management of complications after total wrist arthroplasty, as reported in the literature, with so-called fourth-generation implants and other recent designs. While early intraoperative and postoperative complications, including fractures, tendon lacerations, infection, nerve compression, tendonitis, stiffness and chronic regional pain syndrome, had an acceptable incidence, late complications, such as periprosthetic osteolysis and implant loosening, occurred more frequently. Implant survival at 10 years was in the range of 70%-80% in most publications. Several of the implants have been modified or withdrawn. Instability and dislocation were frequent after a pyrocarbon spacer. Failed arthroplasties can be salvaged by revision arthroplasty or total wrist arthrodesis. Revision arthroplasty has a lower survival rate than primary arthroplasty and does not clearly offer important significant advantages over total wrist arthrodesis in terms of patient-reported outcome measures. Further development of prosthetic design, new materials and more knowledge on patient-related risk factors are needed.
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5
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Smith AM, Maling LC, Williamson M. Total wrist arthroplasty: commentary and opinions. J Hand Surg Eur Vol 2024; 49:115-118. [PMID: 37882664 DOI: 10.1177/17531934231209638] [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: 10/27/2023]
Abstract
Total wrist arthroplasty (TWA) is gaining interest as a management option for wrist arthritis. This review article summarizes the current evidence base for TWA, focusing on the performance and survivorship of fourth-generation implants. These appear to offer satisfactory patient-reported outcomes and survivorship over the medium term, but heterogeneity between implants and patient populations complicates data interpretation. We discuss issues facing TWA practice, including surgical competency, volume, implant development and stewardship. We acknowledge the need for further research on this topic and highlight a number of questions that need answering.
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Affiliation(s)
- Andrew M Smith
- Trauma & Orthopaedics, Queen Elizabeth the Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust, Margate, UK
| | - Lucy C Maling
- Trauma & Orthopaedics, Queen Elizabeth the Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust, Margate, UK
| | - Mark Williamson
- Trauma & Orthopaedics, Queen Elizabeth the Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust, Margate, UK
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6
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Chong HH, Zabaglo M, Asif A, Boksh K, Kulkarni K. A systematic review and network meta-analysis of outcomes after total wrist arthroplasty in inflammatory and non-inflammatory arthritis. J Hand Surg Eur Vol 2024; 49:17-24. [PMID: 37694836 DOI: 10.1177/17531934231199317] [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: 09/12/2023]
Abstract
This systematic review analysed the available evidence on the clinical outcomes of total wrist arthroplasty (TWA) in patients with inflammatory and non-inflammatory arthritis. After screening, 12 studies met the inclusion criteria. They involved 359 patients with 378 TWA implants. The results showed that TWA significantly improved Disabilities of the Arm, Shoulder and Hand (DASH)/Quick-DASH scores and pain visual analogue scale scores in both arthritis groups compared with preoperative values. However, there was no statistically significant difference in the outcome scores between the two groups. Three studies reported Patient-Rated Wrist Evaluation (PRWE) scores, and TWA significantly improved PRWE scores in non-inflammatory arthritis but not in inflammatory arthritis, with no significant difference in postoperative outcome scores between the two groups. Although the included studies have limitations, the review suggests that TWA may be a successful treatment for wrist pain in individuals with either inflammatory or non-inflammatory arthritis. However, further high-quality trials are needed to confirm these findings.
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Affiliation(s)
- Han Hong Chong
- Department of Trauma & Orthopaedic, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Mate Zabaglo
- Department of Trauma & Orthopaedic, Northampton General Hospital NHS Trust, Northampton, UK
| | - Aqua Asif
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Khalis Boksh
- Department of Trauma & Orthopaedic, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Kunal Kulkarni
- Department of Trauma & Orthopaedic, University Hospitals of Leicester NHS Trust, Leicester, UK
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7
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Redfern JAI, Mehta N, Farnebo S, McGuire D, Solomons M, Thomas Thorvaldson K, Estfan R, Brown DJ. Complication rates and modes of short and medium-term failure in Motec total wrist arthroplasty: an international cohort study. J Hand Surg Eur Vol 2024; 49:27-33. [PMID: 37684024 DOI: 10.1177/17531934231195689] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
The aim of this study was to analyse the short- and medium-term complications of the Motec total wrist arthroplasty (TWA). Identifying exact modes of failure and their causes should allow surgeons to avoid or mitigate these risks in the future. Retrospective analysis of prospectively collected data from six hand surgeons at five international centres provided details of 171 Motec TWAs. The mean follow-up was 5.8 years (range 18 months to 12 years). There were 33 (19%) complications within our cohort, with a revision rate of 8.2% (14 revisions). There was no difference in complication rates between metal-on-metal and metal-on-polymer articulations. Failure of osseointegration was the most common complication. Problems with soft tissue balancing, implant impingement related osteolysis, bony impingement and metacarpal fracture were found to be other preventable causes of failure in this series. Elimination of these preventable complications will improve survival rates for this implant.Level of evidence: IV.
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Affiliation(s)
- James A I Redfern
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Nisarg Mehta
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Simon Farnebo
- Department of Plastic Surgery, Hand Surgery, and Burns, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Duncan McGuire
- Martin Singer Hand Unit, Groote Schuur Hospital, Cape Town, South Africa
| | - Michael Solomons
- Martin Singer Hand Unit, Groote Schuur Hospital, Cape Town, South Africa
| | - K Thomas Thorvaldson
- Maitland Hospital, University of Newcastle clinical school, Maitland, NSW, Australia
| | - Rami Estfan
- Southend University Hospital, Mid and South Essex NHS Trust, Southend On Sea, UK
| | - Daniel J Brown
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
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8
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Reiser D, Fischer P, Pettersson K, Wretenberg P, Sagerfors M. Total Wrist Arthroplasty With a New Design, 20 Cases With 8-Year Follow-Up. J Hand Surg Am 2023:S0363-5023(23)00446-X. [PMID: 37715756 DOI: 10.1016/j.jhsa.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 09/18/2023]
Abstract
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. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
- Daniel Reiser
- Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Per Fischer
- Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Kurt Pettersson
- Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Per Wretenberg
- Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Marcus Sagerfors
- Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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9
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Zheng C, Yu G, Su Q, Wu L, Tang J, Lin X, Chen Y, Guo Z, Zheng F, Zheng H, Lin L, Tang Y, Wu S, Li H. The deficiency of N6-methyladenosine demethylase ALKBH5 enhances the neurodegenerative damage induced by cobalt. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 881:163429. [PMID: 37072102 DOI: 10.1016/j.scitotenv.2023.163429] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/23/2023] [Accepted: 04/06/2023] [Indexed: 06/01/2023]
Abstract
Cobalt exposure, even at low concentrations, induces neurodegenerative damage, such as Alzheimer's disease (AD). The specific underlying mechanisms remain unclear. Our previous study demonstrated that m6A methylation alteration is involved in cobalt-induced neurodegenerative damage, such as in AD. However, the role of m6A RNA methylation and its underlying mechanisms are poorly understood. In this study, both epidemiological and laboratory studies showed that cobalt exposure could downregulate the expression of the m6A demethylase ALKBH5, suggesting a key role for ALKBH5. Moreover, Methylated RNA immunoprecipitation and sequencing (MeRIP-seq) analysis revealed that ALKBH5 deficiency is associated with neurodegenerative diseases. KEGG pathway and Gene ontology analyses further revealed that the differentially m6A-modified genes resulting from ALKBH5 downregulation and cobalt exposure were aggregated in the pathways of proliferation, apoptosis, and autophagy. Subsequently, ALKBH5 deficiency was shown to exacerbate cell viability decline, motivate cell apoptosis and attenuate cell autophagy induced by cobalt with experimental techniques of gene overexpression/inhibition. In addition, morphological changes in neurons and the expression of AD-related proteins, such as APP, P-Tau, and Tau, in the cerebral hippocampus of wild-type and ALKBH5 knockout mice after chronic cobalt exposure were also investigated. Both in vitro and in vivo results showed that lower expression of ALKBH5 aggravated cobalt-induced neurodegenerative damage. These results suggest that ALKBH5, as an epigenetic regulator, could be a potential target for alleviating cobalt-induced neurodegenerative damage. In addition, we propose a novel strategy for the prevention and treatment of environmental toxicant-related neurodegeneration from an epigenetic perspective.
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Affiliation(s)
- Chunyan Zheng
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Guangxia Yu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Qianqian Su
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Lingyan Wu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Jianping Tang
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Xinpei Lin
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Yao Chen
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Zhenkun Guo
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Fuli Zheng
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Hong Zheng
- Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou 350007, China
| | - Liqiong Lin
- Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou 350007, China
| | - Ying Tang
- Fujian Center for Prevention and Control Occupational Diseases and Chemical Poisoning, Fuzhou 350125, China
| | - Siying Wu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
| | - Huangyuan Li
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350122, China; Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
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10
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Li Z, Chen M, Wang Z, Fan Q, Lin Z, Tao X, Wu J, Liu Z, Lin R, Zhao C. Berberine inhibits RA-FLS cell proliferation and adhesion by regulating RAS/MAPK/FOXO/HIF-1 signal pathway in the treatment of rheumatoid arthritis. Bone Joint Res 2023; 12:91-102. [PMID: 36718649 PMCID: PMC9950669 DOI: 10.1302/2046-3758.122.bjr-2022-0269.r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
AIMS Rheumatoid arthritis (RA) is a common chronic immune disease. Berberine, as its main active ingredient, was also contained in a variety of medicinal plants such as Berberaceae, Buttercup, and Rutaceae, which are widely used in digestive system diseases in traditional Chinese medicine with anti-inflammatory and antibacterial effects. The aims of this article were to explore the therapeutic effect and mechanism of berberine on rheumatoid arthritis. METHODS Cell Counting Kit-8 was used to evaluate the effect of berberine on the proliferation of RA fibroblast-like synoviocyte (RA-FLS) cells. The effect of berberine on matrix metalloproteinase (MMP)-1, MMP-3, receptor activator of nuclear factor kappa-Β ligand (RANKL), tumour necrosis factor alpha (TNF-α), and other factors was determined by enzyme-linked immunoassay (ELISA) kit. Transcriptome technology was used to screen related pathways and the potential targets after berberine treatment, which were verified by reverse transcription-polymerase chain reaction (RT-qPCR) and Western blot (WB) technology. RESULTS Berberine inhibited proliferation and adhesion of RA-FLS cells, and significantly reduced the expression of MMP-1, MMP-3, RANKL, and TNF-α. Transcriptional results suggested that berberine intervention mainly regulated forkhead box O (FOXO) signal pathway, prolactin signal pathway, neurotrophic factor signal pathway, and hypoxia-inducible factor 1 (HIF-1) signal pathway. CONCLUSION The effect of berberine on RA was related to the regulation of RAS/mitogen-activated protein kinase/FOXO/HIF-1 signal pathway in RA-FLS cells.Cite this article: Bone Joint Res 2023;12(2):91-102.
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Affiliation(s)
- Zhiqi Li
- Beijing University of Chinese Medicine, Beijing, China,Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, Beijing, China
| | - Meilin Chen
- Beijing University of Chinese Medicine, Beijing, China,Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, Beijing, China
| | - Zhaoyi Wang
- Beijing University of Chinese Medicine, Beijing, China,Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, Beijing, China
| | - Qiqi Fan
- Beijing University of Chinese Medicine, Beijing, China,Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, Beijing, China
| | - Zili Lin
- Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoyu Tao
- Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, Beijing, China
| | - Jiarui Wu
- Beijing University of Chinese Medicine, Beijing, China
| | - Zhenquan Liu
- Beijing University of Chinese Medicine, Beijing, China
| | - Ruichao Lin
- Beijing University of Chinese Medicine, Beijing, China,Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, Beijing, China
| | - Chongjun Zhao
- Beijing University of Chinese Medicine, Beijing, China,Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, Beijing, China, Mr. Chongjun Zhao. E-mail:
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11
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Cai X, Wang B, Zhang B, Zhang Y, Wang T, Lin W, Huang Y, Chen B, Zhou S, Lu S, Xu Y. Safety and efficacy of a novel three-dimensional printed microporous titanium prosthesis for total wrist arthroplasty in the treatment of end-stage wrist arthritis. Front Bioeng Biotechnol 2023; 10:1119720. [PMID: 36704301 PMCID: PMC9871302 DOI: 10.3389/fbioe.2022.1119720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Background: Total wrist arthroplasty is an effective treatment for end-stage wrist arthritis from all causes. However, wrist prostheses are still prone to complications such as prosthesis loosening and periprosthetic fractures after total wrist arthroplasty. This may be due to the wrist prosthesis imprecise matching with patient's bone. In this study, we designed and developed a personalized three-dimensional printed microporous titanium artificial wrist prosthesis (3DMT-Wrist) for the treatment of end-stage wrist joint, and investigated its safety and effectiveness. Methods: Total wrist arthroplasty was performed using 3DMT-Wrist in 14 cases of arthritis between February 2019 and December 2021. Preoperative and postoperative visual analog scale scores, QuickDASH scores, wrist range of motion, and wrist grip strength were evaluated. Data were statistically analyzed using the paired samples t-test. Results: After 19.7 ± 10.7 months of follow-up, visual analog scale decreased from 66.3 ± 8.9 to 6.7 ± 4.4, QuickDASH scores decreased from 47.4 ± 7.3 to 28.2 ± 7.6, grip strength increased from 5.6 ± 1.4 to 17.0 ± 3.3 kg. The range of motion improved significantly in palmar flexion (30.1° ± 4.9° to 44.9° ± 6.5°), dorsal extension (15.7° ± 3.9° to 25.8° ± 3.3°), ulnar deviation (12.2° ± 3.9° to 20.2° ± 4.3°) and radial deviation (8.2° ± 2.3° to 16.2 ± 3.1). No dislocation or loosening of the prosthetic wrist joint was observed. Conclusion: Total wrist arthroplasty using 3DMT-Wrist is a safe and effective new treatment for various types of end-stage wrist arthritis; it offers excellent pain relief and maintains the range of motion.
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Affiliation(s)
- Xingbo Cai
- Graduate School, Kunming Medical University, Kunming, China,Department of Orthopedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Bin Wang
- Graduate School, Kunming Medical University, Kunming, China,Department of Orthopedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Bihuan Zhang
- Graduate School, Kunming Medical University, Kunming, China,Department of Orthopedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Yue Zhang
- Graduate School, Kunming Medical University, Kunming, China,Department of Orthopedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Teng Wang
- Department of Orthopedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | - Wei Lin
- Department of Orthopedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China
| | | | | | - Siyuan Zhou
- Suzhou MicroPort OrthoRecon Co., Suzhou, China
| | - Sheng Lu
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, Kunming, China,*Correspondence: Sheng Lu, ; Yongqing Xu,
| | - Yongqing Xu
- Department of Orthopedics, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, China,*Correspondence: Sheng Lu, ; Yongqing Xu,
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