Clarke Sylvan, Hagberg William, Kaufmann Robert A, Grand Aaron, Wollstein Ronit
Hand (N Y). 2011 Sep;6(3):282-6. doi: 10.1007/s11552-011-9332-x. Epub 2011 Apr 9.
Complications with the use of the Artelon spacer in thumb carpometacarpal (CMC) joint arthritis include inflammation, osteolysis, and persistent pain. We evaluated our short-term results and complications.
A retrospective review of 29 patients was performed. Pre- and postoperative radiographs, operative techniques, complications, and subsequent surgeries were analyzed. Pearson's and chi-squared testing was used to identify associations between complications and surgical technique or preoperative radiographic criteria. The average age was age 51 ± 7.7 (34-66), average follow-up was 8 months (1-26).
Twelve patients sustained complications. Nine patients displayed postoperative osteolysis. Four patients underwent conversion to CMC suspensionplasty due to persistent pain. The rate of revision surgery and radiographic postoperative osteolysis were not significantly associated with preoperative arthritis grade, metacarpal subluxation, or surgical techniques: fixation method, the bony surface(s) involved in the osteotomy, or spacer modifications.
Our study found a significant short-term complication rate following Artelon spacer arthroplasty of the CMC joint. This is higher than previously described. We could not identify any factors that were significantly associated with the complications. It is possible that the inherent instability of the joint or the material of the spacer is involved in implant failure. Further study is necessary to better define the indications for use and specific techniques for the use of the implant.
在拇指腕掌关节(CMC)关节炎中使用Artelon间隔器的并发症包括炎症、骨质溶解和持续性疼痛。我们评估了我们的短期结果和并发症。
对29例患者进行回顾性研究。分析术前和术后的X线片、手术技术、并发症及后续手术情况。采用Pearson检验和卡方检验来确定并发症与手术技术或术前影像学标准之间的关联。平均年龄为51±7.7岁(34 - 66岁),平均随访时间为8个月(1 - 26个月)。
12例患者出现并发症。9例患者术后出现骨质溶解。4例患者因持续性疼痛改行CMC悬吊成形术。翻修手术率和术后影像学骨质溶解与术前关节炎分级、掌骨半脱位或手术技术(固定方法、截骨涉及的骨面或间隔器改良)均无显著关联。
我们的研究发现,CMC关节Artelon间隔器置换术后短期并发症发生率较高,高于先前报道。我们未能确定任何与并发症显著相关的因素。关节的固有不稳定性或间隔器材料可能与植入物失败有关。需要进一步研究以更好地确定该植入物的使用指征和具体使用技术。