gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Total Wrist replacement using the MOTEC® PEEK Cup

Meeting Abstract

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  • presenting/speaker Senthooran Raja - Southend University Hospital, Essex, United Kingdom
  • Francesca Hill Cooper - Southend University Hospital, Essex, United Kingdom
  • Rami Estfan - Southend University Hospital, Essex, United Kingdom
  • Gregory John Packer - Southend University Hospital, Essex, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1397

doi: 10.3205/19ifssh0634, urn:nbn:de:0183-19ifssh06342

Published: February 6, 2020

© 2020 Raja et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: We aim to assess the efficacy, functional outcomes and safety of patients undergoing total wrist replacement (TWR) using the MOTEC® PEEK cup. All patients had debilitating wrist arthritis either primary or secondary. This new device is modular in design compared to the previous MOTEC Cup which used a pure cobalt chromium molybdenum alloy (CoCrMo) articulation. The new design introduces a carbon fibre reinforced PEEK articulation on CoCrMo. The intended properties of the PEEK cup include reduced stress distribution, elimination of metal on metal ion concerns and improved durability long term.

Methods: This is a prospective case series of 38 patients who underwent a MOTEC TWR between Nov 2016 & Aug 2018 across two hospital sites under two surgeons using the PEEK cup 15mm diameter. Indications for TWR included persistent pain, malalignment or instability, failure of previous surgery such as primary wrist replacement, four corner fusion, proximal row carpectomy, fixation or arthrodesis. We recorded functional outcomes pre- and post-surgery.

Patients were followed up to minimum of 12 months. Functional assessments used were PRWE, MAYO, QuickDASH scores.

Results: The series had a distribution of 20 male and 18 female patients, age range 33-83 (mean 62.6). Most patients were tertiary referrals and had surgery as a 23-hour stay. Using the PRWE, MAYO, QuickDash scores allowed us to determine post-operative function with minimal loss at follow up. There was a significant improvement in functional outcomes using the PEEK cup. There were no serious adverse events.

Conclusions: Overall the PEEK MOTEC cup showed safe and improved functional outcomes at 6 months and one-year post-surgery. There are no obvious safety concerns and patient satisfaction was rated high with patients being discharged from hand clinic rapidly after surgery.

Patients returned to improved levels of function with dramatically reduced pain. This case series shows that the PEEK MOTEC cup to be a safe and effective implant in TWR. It also reduces the metal on metal complications.