van Rijn J, Gosens T
Department of Orthopedics, Elisabeth Hospital, The Netherlands.
J Hand Surg Am. 2010 Apr;35(4):572-9. doi: 10.1016/j.jhsa.2009.12.026. Epub 2010 Feb 24.
The purpose of this study was to evaluate a cemented prosthesis (Avanta SR TMC prosthesis; Avanta Orthopaedics, San Diego, CA) of the basal thumb joint on the outcomes of range of motion, strength, pain, function, and loosening.
Between July 2004 and December 2007, a total of 15 prostheses in 13 patients were implanted, with an average follow-up period of 36 months (range, 21-63 mo). Before and during the follow-up, the following scores were recorded: Kapandji-score (range of opposition), strength (hand dynamometer and pinch meter), pain (sequential occupational dexterity assessment [SODA], and Michigan Hand Outcomes Questionnaire [MHQ]) and function (9-hole peg test, SODA and MHQ). Radiographs taken before and after surgery were reviewed.
The measurements of range of opposition and strength did not show any significant postoperative improvement. Pain during activities (SODA) decreased significantly, and the function with both hands (SODA and MHQ) improved significantly after surgery. The review of pre- and postoperative radiographs did not show any signs of implant loosening after surgery. One failure and one nerve injury occurred.
In this group of patients, the Avanta SR TMC prosthesis provided statistically significant improvements in function with both hands and in pain during activity, but no significant change in range of motion, strength, or in function of the operated hand used alone. Prosthesis loosening was not detected.
本研究旨在评估一种基底拇指关节的骨水泥假体(Avanta SR TMC假体;Avanta Orthopaedics,加利福尼亚州圣地亚哥)在活动范围、力量、疼痛、功能和松动方面的效果。
在2004年7月至2007年12月期间,共为13例患者植入了15个假体,平均随访期为36个月(范围为21 - 63个月)。在随访前和随访期间,记录了以下评分:卡潘迪评分(对掌范围)、力量(手握力计和捏力计)、疼痛(连续职业灵巧性评估[SODA]和密歇根手功能结果问卷[MHQ])以及功能(9孔插钉试验、SODA和MHQ)。对手术前后拍摄的X线片进行了复查。
对掌范围和力量的测量结果显示术后没有显著改善。活动时的疼痛(SODA)显著降低,双手功能(SODA和MHQ)在术后有显著改善。手术前后X线片的复查未显示术后有任何植入物松动迹象。发生了1例失败病例和1例神经损伤。
在这组患者中,Avanta SR TMC假体在双手功能以及活动时的疼痛方面有统计学意义的显著改善,但在活动范围、力量或单独使用手术手的功能方面没有显著变化。未检测到假体松动。