• No results found

Hemi and total wrist arthroplasty

N/A
N/A
Info
Download
Protected

Academic year: 2021

Share "Hemi and total wrist arthroplasty"

Copied!
2
0
0

Loading.... (view fulltext now)

Download now ( 2 Page )

Full text

(1)

Hemi and total wrist arthroplasty

av

Per Fischer

Akademisk avhandling

Avhandling för medicine doktorsexamen i medicin, som kommer att försvaras offentligt fredagen den 22 november 2019 kl. 13.00, Hörsal C3, Campus USÖ, Örebro Universitet

Opponent: Professor Jan Fridén Institutionen för kliniska vetenskaper Sahlgrenska akademin, Göteborg Universitet

Örebro universitet

Institutionen för medicin och vård 701 82 ÖREBRO

(2)

Abstract

Per Fischer (2019): Hemi and total wrist arthroplasty. Örebro Studies in Medicine 198.

Aim: To study implant survival and implant loosening following primary

total wrist arthroplasty (TWA) using four different implants. To report out-come following wrist revision arthroplasty. To evaluate a new radial wrist hemi arthroplasty (RWHA) design clinically and biomechanically.

Method: The studies included 136 primary TWAs and 16 revision

TWAs, both studies with prospectively collected data. Six fresh frozen ca-daveric wrist specimen were used for biomechanical analysis. The RHWA was evaluated clinically in a pilot series of 20 cases.

Results: Total implant survival was 92% but with high frequency of

implant loosening of surviving Re-Motion implants. None of the surviving Maestro implants were considered radiographically loose. Implant survival following revision arthroplasty was 75%, considerably lower than follow-ing primary TWAs. However, none of the patients with survivfollow-ing revision implants had pain at rest and little or no pain in activity. The surgical pro-cedure and placement of the RHWA was feasible. Overall, the kinematic and functional changes appeared acceptable compared to the native wrist. None of the patients underwent revision following RHWA but reoperation was performed in 7 patients on the indication of persistent pain. However, patients reported relief of pain and improvement of patient-reported out-come measures.

Conclusion: High long-term implant survival and no signs of

radio-graphic loosening was found for the Maestro implant. However, the Maes-tro implant is no longer available on the market and we believe there is a need for new TWA designs. Revision arthroplasty is a valid option in the management of failed TWA. However, implant survival is lower than for primary TWAs and as many as 25% require additional surgery. Promising results were found using the new RHWA design but the implant needs mod-ification before further testing.

Keywords: Rheumatoid arthritis, Wrist, Arthroplasty, Implant survival,

Biomechanics

Per Fischer, School of Medical Science

References

Download now ( PDF - 2 Page - 105.66 KB )

Related documents

The role of head size in total hip arthroplasty

Only when head size became large enough to approximate the anatomic head diameter, was there any significant reduction in the risk of revision due to dislocation, as shown in

The role of head size in total hip arthroplasty

[r]

Living with a recalled implant: a qualitative study of patients' experiences with ASR hip resurfacing arthroplasty

Qualitative semi-structured interviews were conducted with 14 patients where a majority actively sought for metal- on-metal hip resurfacing arthroplasty (HRA), and

Outcomes following primary total hip arthroplasty

[r]

Outcomes following primary total hip arthroplasty

The mortality rate in the study was low (zero point two per cent) and we were unable to find any association between 90-day mortality and an- nual surgeon volume. For Paper II,

SAHLGRENSKA AKADEMIN Outcomes following primary total hip arthroplasty

(Paper IV). In paper I we included 12,100 primary THAs due to osteoarthritis performed at ten hospitals in western Swe- den during year 2011-2016. The aim for this study was

Association between patient survival following reoperation after total hip replacement and the reason for reoperation: an analysis of 9,926 patients in the Swedish Hip Arthroplasty Register

At 5 years patients with a 1st-time reoperation for aseptic loosening had higher survival than expected; however, reoperations per- formed for periprosthetic fracture,

Total wrist arthroplasty

Aim: To study patient-related functional outcome measures, implant survival and radiographic loosening after total wrist arthroplasty (TWA) using four different implants..