gms | German Medical Science

Objectives/Interrogation: We have accumulated 10 years experience of endoprosthetics of the wrist joint. In Novosibirsk RNITO named Tsivyan used whole ceramic unbonded endoprosthesis Moje keramik MBW.

The model uses one short distal stalk inserted into the capitatum bone and one short proximal leg inserted into the radial bone. The configuration of the distal ceramic component is circular, while the proximal component is elliptical.

Such a construction feature allows to initially exclude cutting forces when moving in the wrist joint. The installation of the distal component in the capitatum allows preserving the interaction of the locomotor apparatus of the distal row of the bones of the wrist and carpometacarpal joints, which performs the damping function of the entire wrist joint.

Methods: In the traumatologic and orthopedic department 6 of the Novosibirsk RNITO named Tsivyan in the period from 2010 to December 2017, performed 52 total endoprosthetics of the wrist joint using the Moje MBW ceramic implant. Patients admitted for surgical treatment can be divided into three groups. The first, the most numerous, included patients who underwent traumatic injury of the wrist joint (n = 38).

The second group included patients with osteochondropathy of the wrist joint (n = 9). The third group includes patients suffering from rheumatoid arthritis (n = 5). The latter group, in our opinion, is the most problematic in view of the pronounced osteoporosis and systemic lesion of the ligamentous apparatus. For this reason, 5 operations were performed with minimal changes from the soft tissue side.

Results and Conclusions: In the preoperative period, patients underwent X-ray examination of the affected area in standard straight and lateral projections. Patients with severe deformity and osteolysis performed a tomography study to determine the extent of bone tissue damage. Patients with rheumatoid arthritis, in addition to clinical examination, densitometry was performed to determine the degree of osteopenia. In the detection of osteoporosis, surgery was not performed. Operative intervention was carried out according to the rules of technology.

A year after surgery, patients clearly understand the presence of an endoprosthesis of the wrist joint and assess changes in the quality of life. On average, on a ten-point scale of pain intensity decreases from 9 to 4. According to the Mayo wrist score, an increase in scoring from 30 to 70 is noted.