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手部软骨膜再表面化关节成形术

Perichondrial resurfacing arthroplasty in the hand.

作者信息

Seradge H, Kutz J A, Kleinert H E, Lister G D, Wolff T W, Atasoy E

出版信息

J Hand Surg Am. 1984 Nov;9(6):880-6. doi: 10.1016/s0363-5023(84)80072-6.

Abstract

A retrospective study of 36 perichondrial resurfacing arthroplasties, 16 metacarpophalangeal (MP) joints, and 20 proximal interphalangeal (PIP) joints with a minimum follow-up of 3 years was conducted to further define indication and contraindication of this procedure. The overall results for MP joints were 56% good, 25% fair, and 19% revision, and for PIP joints, 55% good, 15% fair, and 30% revision. All arthroplasties for healed pyarthrosis failed. Concomitant tendon repair was a cofactor in the high failure rate. Patient age had a direct influence on the outcome of the arthroplasty. In MP joint arthroplasties, 100% of patients in their 20s had good results and 75% in their 30s had good results. In PIP joint arthroplasties, 75% of patients in their teens and 66% in their 20s had good results. Good results were not recorded in MP or PIP joints for patients older than 40 years of age. Perichondrial resurfacing arthroplasty should be considered contraindicated in the treatment of arthropathies resulting from healed pyarthrosis, systemic diseases with joint involvement, concomitant tendon reconstruction, and age over 40 years. The procedure is indicated and can be utilized in the treatment of traumatic arthritis of the MP and PIP joints of the hand in young individuals.

摘要

对36例软骨膜表面置换关节成形术进行了一项回顾性研究,其中包括16个掌指(MP)关节和20个近端指间(PIP)关节,随访时间最短为3年,以进一步明确该手术的适应证和禁忌证。MP关节的总体结果为56%良好、25%一般、19%需翻修;PIP关节的结果为55%良好、15%一般、30%需翻修。所有用于治疗愈合性脓性关节炎的关节成形术均失败。同时进行肌腱修复是高失败率的一个辅助因素。患者年龄对关节成形术的结果有直接影响。在MP关节成形术中,20多岁的患者100%结果良好,30多岁的患者75%结果良好。在PIP关节成形术中,十几岁的患者75%结果良好,20多岁的患者66%结果良好。40岁以上的患者在MP或PIP关节均未获得良好结果。对于由愈合性脓性关节炎、累及关节的全身性疾病、同时进行肌腱重建以及年龄超过40岁所导致的关节病,软骨膜表面置换关节成形术应被视为禁忌。该手术适用于年轻个体手部MP和PIP关节创伤性关节炎的治疗,并可加以应用。

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