Service d'Orthopédie, Traumatologie, Chirurgie Plastique et Assistance main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25000 Besançon, France; Laboratoire de Nanomédecine, Imagerie et Thérapeutique EA4662, Université Bourgogne Franche-Comté, 16 Route de Gray, 25000 Besançon, France.
Service de Gynécologie-Obstétrique, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25000 Besançon, France.
Hand Surg Rehabil. 2022 Sep;41(4):463-469. doi: 10.1016/j.hansur.2022.04.007. Epub 2022 May 6.
Trapeziometacarpal arthroplasty is a well-known treatment of thumb basal joint arthritis. However, only a few studies have been done on its use specifically in men, with one of the most recent showing a high implant failure rate. Our study was a retrospective analysis of the ISIS prosthesis exclusively in men. Our hypothesis was that it is a viable therapeutic solution. Between 2010 and 2020, 23 ISIS prostheses were implanted in 19 patients. A radiological and functional analysis was done, combined with a self-evaluation by multiple validated outcome scores (visual analog scale for pain, QuickDASH, PRWE, SF36, and Kapandji scores). The median follow-up was 76 months (13-134) with a median age of 69 years. The mean pain level was 1/10, the QuickDASH was 22.7, the PRWE was 14.2, the SF-36 was 61.1 and the Kapandji score was 8.9. One dislocation occurred in one patient; two patients had to be reoperated for periprosthetic ossifications. Radiolucency was found around the cup in one patient and around the metacarpal shaft in one patient. There was no implant failure and only one case of asymptomatic loosening, with a survival rate of 94% at 111 months. In the medium-term, clinical, and functional outcomes were satisfactory with pain relief similar to that of published studies, with a low rate of complications. ISIS arthroplasty appears to be a suitable treatment for thumb basal joint arthritis in men, although a non-negligible rate of periprosthetic ossifications required revision surgery in half of the cases.
掌腕关节成形术是治疗拇指基底部关节炎的一种知名方法。然而,仅有少数研究专门针对男性进行了研究,其中最近的一项研究显示其假体植入物失败率较高。我们的研究仅针对男性的 ISIS 假体进行了回顾性分析。我们的假设是,这是一种可行的治疗方案。在 2010 年至 2020 年期间,19 名患者共植入了 23 个 ISIS 假体。我们进行了影像学和功能分析,并结合了多种经过验证的结局评分(疼痛视觉模拟评分、QuickDASH、PRWE、SF36 和 Kapandji 评分)的自我评估。中位随访时间为 76 个月(13-134 个月),中位年龄为 69 岁。平均疼痛评分为 1/10,QuickDASH 评分为 22.7,PRWE 评分为 14.2,SF-36 评分为 61.1,Kapandji 评分为 8.9。1 名患者发生 1 次假体脱位,2 名患者因假体周围骨化而行再次手术。1 名患者在杯周围发现透亮线,1 名患者在掌骨干周围发现透亮线。无假体失败,仅 1 例无症状松动,111 个月时的生存率为 94%。在中期,临床和功能结局令人满意,疼痛缓解与已发表的研究相似,并发症发生率较低。ISIS 关节成形术似乎是男性拇指基底部关节炎的一种合适治疗方法,尽管有一半的病例需要翻修手术来处理假体周围骨化。