Comparative functional analysis between pyrolytic carbon prostheses and ligamentous suspension/reconstruction in the treatment of rhizarthrosis.

Autor: Cuenca-Llavall M; Unidad de Cirugía de Mano y Codo, Traumatología Lenox Corachan, Clínica Corachan, Barcelona, España; Unidad de Extremidad Superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital de l'Alt Penedès, Vilafranca del Penedès, España. Electronic address: mcuencall@gmail.com., Lizano-Díez X; Unidad de Cirugía de la Mano, Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España., Cruz-Sánchez M; Unidad de Cirugía de Mano y Codo, Traumatología Lenox Corachan, Clínica Corachan, Barcelona, España; Unidad de Extremidad Superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital Dos de Mayo, Barcelona, España., Cebamanos-Celma J; Unidad de Cirugía de la Mano, Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España., Pidemunt-Moli G; Unidad de Cirugía de la Mano, Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España; Unidad de Cirugía de Mano y Codo, Traumatología Lenox Corachan, Clínica Corachan, Barcelona, España.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cirugia ortopedica y traumatologia (English ed.) [Rev Esp Cir Ortop Traumatol (Engl Ed)] 2018 Sep - Oct; Vol. 62 (5), pp. 373-379. Date of Electronic Publication: 2018 Feb 21.
DOI: 10.1016/j.recot.2018.01.002
Abstrakt: Objective: To evaluate midterm functional outcome after pyrolytic carbon prosthesis (PyroDisk) implantation in the treatment of rhizarthrosis of the thumb, comparing outcomes with those of ligamentous resection/suspension/reconstruction.
Material and Methods: A cross-sectional study retrospectively comparing 2patient groups aged between 40 and 65 years with rhizarthrosis of the thumb. Thirty-two patients operated between 2009 and 2013 were distributed between group i (interposition arthroplasy with PyroDisk implant) and group ii (ligamentous resection/suspension/reconstruction arthroplasty). Data on pain, functionality (Quick-Dash questionnaire) and articular movement were collected in 2015. In addition, a radiological study was undertaken using radiographs and CT.
Results: Thirty-two patients, 16 in each group with mean follow-up of 35 months (23-47). Pain at the end of follow-up was greater in the group with the pyrolytic carbon prosthesis (p=0.000). According to the QuickDash questionnaire, the patients in group i achieved a mean functionality of 31.14 (0-70) points compared to 15.81 (8-24) points for group ii (p=0.027). No differences were found in degree of mobility at the end of follow-up (p=0.46). The prosthesis had to be removed in 6 cases.
Discussion: The pyrolytic carbon prosthesis has been presented as an alternative treatment for rhizarthrosis of the thumb. The papers pubslished to date highlight the discrepancies in midterm functional outcomes.
Conclusions: Pyrolitic carbon prostheses have shown inferior functional outcomes, compared with resection/suspension/reconstruction arthroplasties.
(Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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