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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Pyrocarbon Hemi-Wrist Arthroplasty: 16 Cases – Mean Follow Up Two Years

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  • presenting/speaker Allan Ibsen Sorensen - Sahlgrenska University Hospital, Gothenburg, Sweden
  • Peter Axelsson - Sahlgrenska University Hospital, Gothenburg, Sweden

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. DocIFSSH19-1560

doi: 10.3205/19ifssh0637, urn:nbn:de:0183-19ifssh06377

Published: February 6, 2020

© 2020 Ibsen Sorensen 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: To report our early experiences of a Pyrocarbon Hemi-Wrist prosthesis.

Methods: The RCPI pyrocarbon prosthesis was used for un-cemented hemi-wrist joint arthroplasty. Patients were evaluated pre- and postoperatively for ROM, grip strength and key-pinch. Visual Analogue Scales (0-100 mm) for pain and satisfaction, Quick-DASH and PRWE questionnaires were used as patient reported outcome measures. Radiographs were obtained pre-operatively and at latest follow-up. The procedure was performed in 16 patients (8 men and 8 women). Mean age was 50 years (range 20-68). Mean follow-up was 25 month (range 12-75). The rationale for the procedure was Kienboeck's disease in combination with degenerative arthritis (5 wrists) and posttraumatic arthritis (11 wrists). Five patients had previously undergone wrist surgery. Change between preoperative- and last follow-up measurements were analyzed with Wilcoxon signed rank test.

Results and Conclusions: Wrist extension and flexion were preop 45/40 degrees and at last follow-up (LFU) 40/30 (p=ns). Radial/ulnar deviation was 15/35 degrees versus 15/25 at LFU (p=ns). Grip strength, was preop 19 kgF (range 4-43) and at LFU 26 KgF (range 12-44, p=ns). VAS pain was preop at rest/activity; 55/75 and at LFU; 29/43 (p<.05). Quick DASH and PRWE scores were preop: 60 respectively 67 and at LFU: 38 respectively 32, (p<.05) respectively (p<.01). VAS for Patient's satisfaction were 66 mm (8-100).

No infections was encountered. Two prosthesis were revised, one to a total wrist arthroplasty because of persistent unexplained pain and one to an interposition arthroplasty because of ulnar dislocation of carpus. One patient underwent radial styloidectomy due to impingement. There were no loosening of any implant, but radiolucency in the capitate bone was detected for one patient.

There were little change in ROM and Grip strength but significant improvements of pain, Quick DASH, PRWE scores. Patient's satisfaction was comparatively high and we found the complication rate to be acceptable. Our early results indicate that Pyrocarbon Hemi-Wrist arthroplasty could be a viable option in patients with selected types of wrist arthritis.