Katerla Denise, Schandl René, Wolters Roman, Krimmer Hermann
Zentrum für Hand- und Fußchirurgie, Elisabethenstr. 19, 88212, Ravensburg, Deutschland.
Orthopade. 2022 Jan;51(1):29-35. doi: 10.1007/s00132-021-04196-4. Epub 2021 Dec 17.
The complex kinematics of the saddle joint has been a challenge in the development of trapeziometacarpal prostheses. The introduction of the dual-mobility design increases the range of motion and limits strains on the cup fixation. Therefore, rates of loosening and dislocation have been markedly reduced. Furthermore, several studies showed a similar relief of pain, range of movement and grip strength compared to the results of resection arthroplasty. The preservation of the length of the first ray as well as the more stable and functional joint can be favourable in younger and active patients. Further investigation is needed to determine whether or not those higher demands affect long-term survivorship. The high grade of patient satisfaction, the shorter recovery time and the safe surgical technique motivates considering the implantation of a total endoprosthesis with a dual-mobility cup as an attractive alternative to resection arthroplasty in the operative treatment for trapeziometacarpal osteoarthritis.
鞍状关节复杂的运动学一直是大多角骨-第一掌骨假体研发中的一项挑战。双动设计的引入增加了活动范围,并限制了髋臼固定处的应变。因此,松动和脱位率显著降低。此外,多项研究表明,与切除关节成形术的结果相比,疼痛缓解程度、活动范围和握力相似。保留第一掌骨的长度以及更稳定且功能良好的关节,对于年轻且活跃的患者可能是有利的。需要进一步研究以确定这些更高的要求是否会影响长期生存率。患者的高度满意度、较短的恢复时间以及安全的手术技术,促使人们考虑将带有双动髋臼的全关节假体植入作为大多角骨-第一掌骨骨关节炎手术治疗中切除关节成形术的一种有吸引力的替代方案。