Lerebours Augustin, Marin Frederic, Bouvier Salima, Egles Christophe, Rassineux Alain, Masquelet Alain-Charles
CNRS, FRE2012 Laboratory Roberval, Sorbonne Universities Alliance, University of Technology of Compiègne, Compiègne, France.
CNRS, UMR7338 Laboratory, Biomechanics and Bioengineering, Sorbonne Universities Alliance, University of Technology of Compiègne, Compiègne, France.
J Hand Surg Am. 2020 Mar;45(3):223-238. doi: 10.1016/j.jhsa.2019.11.015. Epub 2020 Jan 25.
Hand function is inseparably linked to the condition of the thumb. The trapeziometacarpal (TMC) joint that provides the different movements of opposition is one of the joints most affected by osteoarthritis, which causes an irreversible deformation of the bone. The ideal thumb carpometacarpal implant must restore range of movement, prevent complications, be biocompatible, and have good mechanical properties (ie, low wear, high corrosion resistance, and osteointegration properties where it is anchored in a bone). The integrity of the implant and the surrounding biological structures must be long-lasting and withstand constant stresses induced by the prosthesis. Three main types of implant systems for the thumb are currently clinically available; others are under investigation in human subjects. This systematic review is based on administrative databases, patents, the literature, and information from orthopedic companies. It provides a summary of strategies and design changes and an overview of the biomechanical characteristics of currently available carpometacarpal implants for treating osteoarthritis of the thumb.
手部功能与拇指状况紧密相连。提供对掌等不同运动的大多角骨-第一掌骨(TMC)关节是受骨关节炎影响最严重的关节之一,骨关节炎会导致骨骼不可逆变形。理想的拇指腕掌关节植入物必须恢复活动范围、预防并发症、具备生物相容性且具有良好的机械性能(即低磨损、高耐腐蚀性以及在骨内锚固处的骨整合性能)。植入物与周围生物结构的完整性必须持久,并能承受假体引发的持续应力。目前临床上有三种主要类型的拇指植入系统可供使用;其他类型正处于人体研究阶段。本系统评价基于管理数据库、专利、文献以及骨科公司提供的信息。它总结了相关策略和设计变更,并概述了当前用于治疗拇指骨关节炎的腕掌关节植入物的生物力学特性。