Institut de la Main Nantes-Atlantique, Santé Atlantique, Avenue Claude Bernard, 44800 Saint-Herblain, France.
Institut de la Main Nantes-Atlantique, Santé Atlantique, Avenue Claude Bernard, 44800 Saint-Herblain, France.
Hand Surg Rehabil. 2020 Dec;39(6):528-538. doi: 10.1016/j.hansur.2020.09.003. Epub 2020 Sep 19.
Many surgical procedures are available for treating trapeziometacarpal (TMC) osteoarthritis (OA). The aim of this study was to analyze the mid- to long-term outcomes of 103 pyrocarbon interposition arthroplasties in the TMC joint with Pyrocardan® implant performed prospectively in a single center to treat painful early stage OA. There were 96 patients with a median age of 59 years. Twenty-eight percent of patients were manual workers and 39% had a fixed dislocation of the first metacarpal. Fifteen percent of patients were 50 years old or more. After a minimum follow-up of 5 years, there was a marked improvement in the pain level (0.6/10), QuickDASH (9/100) and PRWHE (4/100) scores and strength (key pinch 8kg, grip strength 27kg). There were no differences in strength or range of motion compared to the opposite side. Four patients underwent revision surgeries. Two of them were converted to trapeziectomy. The 5-year implant survival rate was 96.2%. Dislocation of the first metacarpal was completely corrected in 80% of cases. Younger patients (≤50 years old) had slightly better outcomes than older ones. Overall satisfaction rate was 96%. Pyrocardan® interposition implant arthroplasty is a reliable alternative to trapeziectomy, total arthroplasty or fusion of the TMC joint especially for young, active patients.
许多手术方法可用于治疗腕掌关节(TMC)骨关节炎(OA)。本研究旨在分析 103 例前瞻性单中心使用 Pyrocardan®植入物行皮洛碳间置关节成形术治疗早期疼痛性 OA 的中期至长期结果。共有 96 例患者,中位年龄 59 岁。28%的患者为体力劳动者,39%的患者存在第一掌骨固定性脱位。15%的患者年龄在 50 岁或以上。随访至少 5 年后,疼痛程度(0.6/10)、QuickDASH(9/100)和 PRWHE(4/100)评分和握力(指间捏力 8kg,握力 27kg)均显著改善。与对侧相比,握力和活动范围无差异。4 例患者行翻修手术。其中 2 例改行腕骨切除术。5 年的植入物存活率为 96.2%。80%的病例第一掌骨脱位完全矫正。≤50 岁的年轻患者比年龄较大的患者结果稍好。总体满意度为 96%。皮洛碳间置植入物关节成形术是腕骨切除术、全关节置换术或 TMC 关节融合术的可靠替代方法,特别适用于年轻、活跃的患者。