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莫杰拇指腕掌关节置换术的高频失败。

High frequency failure of the Moje thumb carpometacarpal joint arthroplasty.

作者信息

Kaszap B, Daecke W, Jung M

机构信息

Department for Orthopaedic Surgery, University of Heidelberg, Heidelberg, Germany.

出版信息

J Hand Surg Eur Vol. 2012 Sep;37(7):610-6. doi: 10.1177/1753193412454252. Epub 2012 Jul 12.

Abstract

Arthroplasty is one of several options for treating symptomatic osteoarthritis of the thumb carpometacarpal joint. There are various hemi- and total arthroplasties available on the market. We report our experience of treating 12 patients with the Moje Acamo CMC1 prosthesis. We reviewed all the patients at a mean of 50 months postoperatively. All patients presented with loosening, migration or tilting of one or both implant components. Nine patients were symptomatic enough to warrant revision surgery with removal of the implant leaving a pseudarthrosis. At the last follow-up, five patients (42%) had already received revision surgery. All patients still possessing an implant showed progressive signs of implant loosening, although some of them had no symptoms. In order to assess their overall disadvantage compared with patients treated by primary trapeziectomy, the outcomes of these two groups were compared (matched pairs). The outcomes after revision surgery were comparable with those of primary trapeziectomy. We no longer use the Moje Acamo CMC1 implant and recommend that patients who have received this implant should be monitored carefully both clinically and radiologically.

摘要

关节成形术是治疗拇指腕掌关节症状性骨关节炎的几种选择之一。市场上有各种半关节成形术和全关节成形术。我们报告了使用Moje Acamo CMC1假体治疗12例患者的经验。我们在术后平均50个月对所有患者进行了复查。所有患者均出现一个或两个植入部件松动、移位或倾斜。9例患者症状严重,需要进行翻修手术,取出植入物,形成假关节。在最后一次随访时,5例患者(42%)已经接受了翻修手术。所有仍保留植入物的患者均显示出植入物松动的进展迹象,尽管其中一些患者没有症状。为了评估与初次大多角骨切除术治疗的患者相比其总体劣势,对这两组患者的结果进行了比较(配对)。翻修手术后的结果与初次大多角骨切除术的结果相当。我们不再使用Moje Acamo CMC1植入物,并建议对接受该植入物的患者进行仔细的临床和影像学监测。

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