晚期腕关节炎采用带植入物关节成形术的近排腕骨切除术的疗效
Outcomes of Proximal Row Carpectomy With Interposition Arthroplasty for Advanced Wrist Arthritis.
作者信息
Adenikinju Abidemi, Wu Kitty Y, Karim Kristin, Carlsen Brian, Kakar Sanjeev
机构信息
Mayo Clinic, Rochester, MN, USA.
出版信息
Hand (N Y). 2024 Nov 23:15589447241298721. doi: 10.1177/15589447241298721.
BACKGROUND
This study aimed to evaluate and compare the outcomes of proximal row carpectomy (PRC) with interposition arthroplasty using dorsal wrist capsule interposition, lateral meniscus allograft, or dermal allograft in patients with lunate facet/capitate degeneration.
METHODS
Patients who underwent PRC with interposition arthroplasty between 2010 and 2022 at a single institution were identified. Preoperative and postoperative visual analog scale (VAS) pain, functional outcomes, and complications were recorded.
RESULTS
Twenty-one patients (11 dorsal capsule, 6 meniscus, 4 dermal matrix) were identified with a mean follow-up of 65.8 months. Postoperative pain and functional outcome scores significantly improved. The mean postoperative Quick Disabilities of the Arm, Shoulder, and Hand score was 20.3. In total, 89.5% of patients returned to work, including 75% of manual laborers.
CONCLUSIONS
No significant differences were found between dorsal capsular flap versus allograft groups. Proximal row carpectomy with interposition arthroplasty is an effective motion-sparing procedure for patients with proximal capitate and/or lunate fossa arthritis, improving pain and function.
背景
本研究旨在评估和比较近端腕骨切除术（PRC）联合使用腕背关节囊植入、异体外侧半月板或异体真皮植入进行间置关节成形术，对月骨小面/头状骨退变患者的治疗效果。
方法
确定2010年至2022年在单一机构接受PRC联合间置关节成形术的患者。记录术前和术后视觉模拟量表（VAS）疼痛评分、功能结果和并发症情况。
结果
共纳入21例患者（11例采用关节囊植入，6例采用半月板植入，4例采用真皮基质植入），平均随访65.8个月。术后疼痛和功能结果评分显著改善。术后手臂、肩部和手部快速残疾评定量表平均评分为20.3分。共有89.5%的患者恢复工作，其中包括75%的体力劳动者。
结论
关节囊瓣组与异体移植组之间未发现显著差异。近端腕骨切除术联合间置关节成形术是治疗近端头状骨和/或月骨窝关节炎患者的一种有效的保留运动功能的手术方法，可改善疼痛和功能。
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