Zijlker Hero Jan Aeilko, Ritt Mathias Joseph Petrus Franciscus, Beumer Annechien
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, The Netherlands.
J Wrist Surg. 2021 Oct 5;11(5):456-464. doi: 10.1055/s-0041-1735840. eCollection 2022 Oct.
The purpose of total wrist arthroplasty is to reduce pain and maintain mobility in a painful destructed wrist. First-, second-, and third-generation total wrist arthroplasties have shown unacceptable outcomes with high failure rates. In 2004, the fourth-generation total wrist implants were introduced to address the clinical problems encountered in the previous generations of total wrist implants. Outcomes and complications of fourth-generation total wrist implants were systematically reviewed in the literature (2004-present), including the Universal 2, ReMotion, Freedom, Motec, and Maestro total wrist implants. The literature search yielded 114 papers, of which 18 (990 implants) were included in this systematic review. The quality of evidence was low. All implants effectively reduced pain and improved functionality of the wrist. The Motec wrist implant demonstrated the highest survival rate at 10 year follow-up (86%). This systematic review suggests a substantial improvement of quality in fourth-generation total wrist arthroplasty.
全腕关节置换术的目的是减轻疼痛，并在疼痛性腕关节破坏时维持其活动能力。第一代、第二代和第三代全腕关节置换术的结果不尽人意，失败率很高。2004年，第四代全腕关节植入物问世，以解决前几代全腕关节植入物所遇到的临床问题。本文系统回顾了文献（2004年至今）中第四代全腕关节植入物的结果及并发症，包括通用2型、ReMotion、Freedom、Motec和Maestro全腕关节植入物。文献检索得到114篇论文，其中18篇（990例植入物）纳入本系统评价。证据质量较低。所有植入物均有效减轻了疼痛并改善了腕关节功能。Motec腕关节植入物在10年随访时显示出最高的生存率（86%）。本系统评价表明第四代全腕关节置换术的质量有了实质性提高。
