Gauthier E, Truffandier M-V, Gaisne E, Bellemère P
Institut de la main Nantes-Atlantique, clinique Jeanne-d'Arc, 21, rue des Martyrs, 44100 Nantes, France.
Institut de la main Nantes-Atlantique, clinique Jeanne-d'Arc, 21, rue des Martyrs, 44100 Nantes, France.
Hand Surg Rehabil. 2017 Apr;36(2):113-121. doi: 10.1016/j.hansur.2017.01.003. Epub 2017 Feb 28.
The aim of this study was to report the results of arthroplasty using a mobile pyrocarbon implant (Pyrocardan) for isolated scaphotrapeziotrapezoid (STT) osteoarthritis. The hypothesis was that this arthroplasty leads to functional improvement without carpal instability. Twenty patients (22 implants) were included with a minimum follow-up of 2 years and an average age of 59.6 years. Outcome criteria were pain (VAS scale), QuickDASH and PRWE scores, strength (grip and pinch), wrist mobility, the Kapandji index, carpal height and the capitolunar angle measured on X-rays. The preoperative data was compared to the postoperative data. The average follow-up was 3.8 years. There was a significant improvement in pain, clinical scores and pinch strength. In terms of range of motion, we found that amplitudes were maintained except for a significant decrease in wrist extension. X-rays did not show any carpal instability; carpal height was maintained and the capitolunar angle was significantly improved. No implant dislocation was reported. The good functional and radiographic outcomes, and the absence of surgical complications are evidence that the Pyrocardan resurfacing implant is a valid option for treating STT osteoarthritis. If this arthroplasty procedure fails, another procedure can still be done. However, a long-term assessment of this technique is still needed.
本研究的目的是报告使用可移动热解碳植入物(Pyrocardan)治疗孤立性舟大多角小多角骨(STT)骨关节炎的关节成形术结果。假设是这种关节成形术能在不导致腕骨不稳定的情况下实现功能改善。纳入了20例患者(22个植入物),最短随访2年,平均年龄59.6岁。结果标准包括疼痛(视觉模拟评分量表)、QuickDASH和PRWE评分、力量(握力和捏力)、腕关节活动度、Kapandji指数、腕骨高度以及X线测量的月骨角。将术前数据与术后数据进行比较。平均随访时间为3.8年。疼痛、临床评分和捏力有显著改善。在活动范围方面,我们发现除了腕关节伸展明显减少外,其他幅度均得以维持。X线未显示任何腕骨不稳定;腕骨高度得以维持,月骨角显著改善。未报告植入物脱位情况。良好的功能和影像学结果以及无手术并发症证明Pyrocardan表面置换植入物是治疗STT骨关节炎的有效选择。如果这种关节成形术失败,仍可进行其他手术。然而,仍需要对该技术进行长期评估。