Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
J Plast Surg Hand Surg. 2024 Apr 2;59:40-45. doi: 10.2340/jphs.v59.34985.
The purpose of this study was to evaluate clinical, patient rated and radiological outcome of the scaphoid trapezium pyrocarbon implant (STPI) at a minimum of three years follow-up.
Consecutive patients operated with the STPI due to scaphotrapeziotrapezoidal (STT) arthritis between 2012 and 2019 were included. Patients were evaluated preoperatively and annually after surgery for range of motion, grip strength, key pinch, quick-DASH, pain, and satisfaction. Radiographs were evaluated for implant position, signs of dorsal intercalated segment instability (DISI), capitolunate (CL) angle, scapholunate (SL) distance, and presence of osteophytes.
Twenty-six patients (29 implants) were included. Seven implants were revised during the follow up, mainly due to pain: three implants were removed, four patients received a new STPI of a different size, leaving 22 implants in 20 patients available for follow up, 9 males and 11 females. Median age was 61.7 years (51-78 years). Median follow-up time was 68 months (37-105 months). Comparing preoperative status to the last follow-up, wrist extension and deviation, thumb abduction, and grip strength did not change. Key Pinch, quick DASH, pain, and patient satisfaction improved significantly at last follow-up. Radiographic signs of DISI were seen in six cases preoperatively and in 12 cases at last follow-up.
At a minimum of three years follow-up, the STPI used for STT-arthritis improve pain, quick-DASH result, and patient satisfaction significantly. ROM and grip strength did not change compared to preoperative values. Radiographic signs of carpal instability were common at the follow-up and the revision rate was high.
本研究旨在评估 scaphoid trapezium pyrocarbon 植入物（STPI）在至少三年随访时的临床、患者评估和影像学结果。
纳入 2012 年至 2019 年间因 scaphotrapeziotrapezoidal（STT）关节炎接受 STPI 手术的连续患者。患者在术前和术后每年进行评估，评估内容包括关节活动度、握力、关键捏力、快速-DASH、疼痛和满意度。对 X 线片进行评估，包括植入物位置、背侧交互段不稳定（DISI）征象、头状月骨（CL）角、舟月骨（SL）距离和骨赘的存在。
共纳入 26 例（29 个植入物）患者。在随访过程中有 7 个植入物需要翻修，主要是由于疼痛：3 个植入物被取出，4 名患者接受了不同大小的新 STPI，20 名患者中有 22 个植入物可供随访，9 名男性和 11 名女性。中位年龄为 61.7 岁（51-78 岁）。中位随访时间为 68 个月（37-105 个月）。与术前相比，末次随访时腕关节伸展和偏斜、拇指外展和握力没有变化。关键捏力、快速-DASH、疼痛和患者满意度在末次随访时显著改善。术前有 6 例出现 DISI 放射学征象，末次随访时 12 例出现该征象。
在至少三年的随访中，STPI 用于治疗 STT-关节炎可显著改善疼痛、快速-DASH 结果和患者满意度。与术前相比，ROM 和握力没有变化。腕关节不稳定的放射学征象在随访时很常见，翻修率较高。
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