Department of Orthopedics, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, SS0 0RY Westcliff-on-Sea, Essex, United Kingdom.
Department of Physiotherapy, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, SS0 0RY Westcliff-on-Sea, Essex, United Kingdom.
Hand Surg Rehabil. 2020 Feb;39(1):53-58. doi: 10.1016/j.hansur.2019.11.001. Epub 2019 Nov 7.
The RegJoint™ (Scaffdex Oy, Finland) implant is a bio-absorbable poly-L/D-lactide implant which acts as a temporary support in resected joint spaces. It can be used in base of thumb surgery as a spacer to prevent first metacarpal subsidence. However, high rates of adverse tissue reactions and bone osteolysis have been reported recently by one group. The objective of this study was to investigate the outcome of patients treated in our institution with this implant. Patients underwent a postoperative clinical and radiological assessment. The QuickDASH questionnaire, Patient Evaluation Measure (PEM) and a visual analogue scale for pain assessment were used. Grip strength, key pinch, pinch strength, thumb palmar and radial abduction and opposition were measured. Trapeziometacarpal height was used to evaluate thumb shortening compared with the preoperative value. Periprosthetic bone-erosion of the trapezium and metacarpal were measured. Subluxation of the joint was evaluated by measuring the step-off between the radial edge of the trapezium and the base of the first metacarpal bone. Twenty-two patients from 2013-2016 were included. There were no postoperative wound complications. There was no significant difference in grip strength, key pinch or pinch between the operated and the contralateral hand. There was no significant difference in the trapeziometacarpal height, trapezial height or the degree of subluxation pre-or post-operatively. Contrary to recent reports, we did not find any adverse soft tissue reactions or significant bone erosion. There was no significant change in hand function. We consider the RegJoint™ a useful adjunct in the management of a select cohort of patients with base of thumb arthritis.
RegJoint™（芬兰 Scaffdex Oy）植入物是一种可生物吸收的聚 L/D-丙交酯植入物，可作为切除关节间隙的临时支撑物。它可用于拇指基底部手术，作为防止第一掌骨下沉的间隔物。然而，最近有一组报道称，该植入物会引起严重的组织不良反应和骨溶解。本研究旨在调查我们机构治疗的患者的治疗效果。患者接受术后临床和影像学评估。使用 QuickDASH 问卷、患者评估量表（PEM）和疼痛视觉模拟评分进行评估。测量握力、拇指对指、捏力、拇指掌侧和桡侧外展以及对掌。使用 trapeziometacarpal 高度评估拇指缩短与术前值的比较。测量 trapezium 和 metacarpal 的骨溶解情况。通过测量 trapezium 桡侧边缘与第一掌骨基底之间的台阶来评估关节半脱位。纳入了 2013-2016 年的 22 名患者。无术后伤口并发症。患侧与对侧手的握力、拇指对指和捏力无显著差异。术前和术后 trapeziometacarpal 高度、trapezium 高度或半脱位程度无显著差异。与最近的报道相反，我们没有发现任何不良的软组织反应或明显的骨质侵蚀。手部功能无明显变化。我们认为 RegJoint™ 是治疗拇指基底部关节炎特定患者的有用辅助工具。
