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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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ARPE-prosthesis: Clinical and radiographic relevance of intra-operative fluoroscopy guided orientation of the cup. Comparison to retrospective data with a minimal follow-up of ten years

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  • presenting/speaker Loïc Vercruysse - AZ Delta, Roeselare, Belgium
  • Sanne Vanstockstraeten - AZ Delta, Roeselare, Belgium
  • Arne Decramer - AZ Delta, Roeselare, Belgium

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. DocIFSSH19-1738

doi: 10.3205/19ifssh1096, urn:nbn:de:0183-19ifssh10969

Published: February 6, 2020

© 2020 Vercruysse 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: It is known that cup placement is considered important to minimize the risk of complications. Up until now, it was based on experience. A study of Duerinckx et al, suggested that there is a fixed relationship between the centre of range of motion and the proximal articular surface of the trapezium (PAST-line).

Primary endpoint in this study is comparing cup inclination and positioning with respect to the PAST-line with and without the PAST-technique. Secondary endpoint in this study is to evaluate clinical outcomes and complications of prostheses with a minimal follow-up of ten years (without the PAST-technique) and compare it to the results of recently placed prostheses (with the PAST-technique) with a follow-up of 12 months.

Methods: We looked for patients meeting the inclusion criteria with trapeziometacarpal arthritis that underwent primary arthroplasty with an ARPE-prosthesis for the retrospective part and the prospective part, between 2002 and 2007 and between 2016 and 2017 respectively. For the retrospective part, the PAST-technique was not used in contrast to the prospective part where intra-operative fluoroscopy for cup placement was used. The same inclusion- and exclusion criteria for both parts of the study were used. Patients got a PA and a lateral Kapandji view postoperatively.

Patients were assessed at follow-up for clinical outcome parameters.

Results and Conclusions: Between 2002 and 2007, 89 patients were enrolled in the study and eventually 37 patients remained for retrospective data collection. Furthermore, prospective data collection occurred for 25 patients, operated on with the use of the PAST-technique.

We intend to obtain demographic data as well as pre- and postoperative mean strength, ROM, Kapandji-,DASH- and VAS scores. Radiographic parameters regarding cup placement such as inclination and the centre of the cup were measured. Finally complications will be notified for the group with a follow-up of more than 10 years which will help us to get insight long-term survival rates.

The survivorship rate of these prostheses is proven in various studies. The clinical results of our patients regarding strength, pain relief and range of motion are promising. Cup placement is of utmost importance to minimize complications such as dislocation and wear but further studies and a longer follow-up with a larger group of patients are needed to detect significant changes regarding the usage of the PAST-technique.