Goubau Jean F, Goubau Laurent, Goorens Chul Ki, van Hoonacker Petrus, Kerckhove Diederick, Vanmierlo Bert, Berghs Bart
Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic, AZ Sint-Jan AV Brugge - Oostende, AZ Sint Lucas, Brugge, Belgium ; Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Gent, Universiteit Gent (UG), Gent, Belgium.
J Wrist Surg. 2015 Feb;4(1):35-42. doi: 10.1055/s-0034-1398487.
Background One of the surgical treatment options for trapeziometacarpal (TMC) joint arthritis is a prosthetic ball-and-socket replacement. One of the complications in the postoperative setting is de Quervain tendinopathy. Purposes Although this complication has been reported following a resection athroplasty, we questioned whether lengthening of the thumb following the Ivory (Memometal, Stryker Corporate, Kalamazoo, MI, USA) ball-and-socket arthroplasty could be a causal factor. Methods In a prospective study regarding the overall outcome of the Ivory prosthesis, we analyzed 96 cases (83 patients; 69 female, 12 male, 8 bilateral) of primary implanted Ivory prosthesis and the incidence of de Quervain disease during the first year following surgery. We found a particularly high incidence (17%) of de Quervain tendinopathy the first year following this ball-and-socket arthroplasty. We measured the lengthening of the thumb radiographically in the group presenting de Quervain and the asymptomatic group and compared this measure between the two groups. Results We did not find any measurable or statistically significant difference between the groups regarding lengthening. Discussion These findings suggest that lengthening of the thumb following ball-and-socket arthroplasty is not a causal factor in the development of de Quervain tendinopathy within one year after surgery.
背景 大多角骨-第一掌骨(TMC)关节关节炎的手术治疗选择之一是球窝假体置换。术后并发症之一是桡骨茎突狭窄性腱鞘炎。目的 尽管在切除关节成形术后已报道过这种并发症,但我们质疑在使用艾弗里(Memometal,史赛克公司,美国密歇根州卡拉马祖)球窝关节成形术后拇指延长是否可能是一个致病因素。方法 在一项关于艾弗里假体总体疗效的前瞻性研究中,我们分析了96例(83例患者;69例女性,12例男性,8例双侧)初次植入艾弗里假体的病例以及术后第一年桡骨茎突狭窄性腱鞘炎的发生率。我们发现在这种球窝关节成形术后第一年桡骨茎突狭窄性腱鞘炎的发生率特别高(17%)。我们对出现桡骨茎突狭窄性腱鞘炎的组和无症状组的拇指进行了影像学测量,并比较了两组之间的这一测量结果。结果 我们在两组之间未发现关于延长方面有任何可测量的或统计学上显著的差异。讨论 这些发现表明,球窝关节成形术后拇指延长不是术后一年内桡骨茎突狭窄性腱鞘炎发生的致病因素。