Hansen Torben Baek, Snerum Lennart
Section of Hand Surgery, Department of Orthopaedics, Regional Hospital Holstebro, Holstebro, Denmark.
Scand J Plast Reconstr Surg Hand Surg. 2008;42(6):316-9. doi: 10.1080/02844310802393974.
The first reports about treating osteoarthrosis of the trapeziometacarpal (TMC) joint with the Elektra prosthesis were encouraging. Based on those, we operated on 17 hands in 16 patients with Eaton stage 3+4 osteoarthritis of the TMC joint using the Elektra hydroxyapatite-coated uncemented TMC prosthesis. There were 15 women and one man, mean age 54 years (range 40-70). At follow-up after 35 months (range 22-52), four patients had been reoperated on because of aseptic loosening of the screw cup with migration and progressive pain. Two other patients have been revised because the implant had to be removed for other reasons. At radiological follow-up in the 11 other patients, one cup had migrated and was clearly loose, leaving 10 implants with no sign of failure. Part of this mediocre result may be explained by the learning curve, but more studies are needed to confirm the excellent results obtained elsewhere with the Elektra prosthesis, and we advise others to monitor their results carefully when using this implant. Studies comparing joint replacement with resection arthroplasty are also needed.
关于使用伊莱克特拉假体治疗第一掌腕(TMC)关节骨关节炎的首批报告令人鼓舞。基于这些报告,我们对16例伊顿3 + 4期TMC关节骨关节炎患者的17只手使用了伊莱克特拉羟基磷灰石涂层非骨水泥型TMC假体进行手术。其中有15名女性和1名男性,平均年龄54岁(范围40 - 70岁)。在35个月(范围22 - 52个月)的随访中,4例患者因螺钉杯无菌性松动伴移位和进行性疼痛而接受了再次手术。另外2例患者因其他原因必须取出植入物而进行了翻修。在对其他11例患者的影像学随访中,有1个杯状假体发生了移位且明显松动,其余10个植入物无失败迹象。这个不太理想的结果部分可能归因于学习曲线,但需要更多研究来证实伊莱克特拉假体在其他地方取得的优异结果,并且我们建议其他人在使用这种植入物时仔细监测其结果。还需要进行比较关节置换与切除关节成形术的研究。