Equally good fixation of cemented and uncemented cups in total trapeziometacarpal joint prostheses.

Background and purpose Cup failure is a recognized problem in total trapeziometacarpal (TM) joint prostheses; it may be related to poor fixation, which can be revealed by radiostereometric analysis (RSA). We compared the early implant migration of cemented trapezium cups to that of uncemented screw...

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Publicado en:Acta Orthopaedica Vol. 84; no. 1; pp. 98 - 106
Autores principales: Hansen, Torben Bæk, Stilling, Maiken
Formato: equations & formulas pictorial research tables/charts Journal Article
Publicado: Medical Journals Sweden AB Feb2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2013
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      pub: Medical Journals Sweden AB
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        atl: Equally good fixation of cemented and uncemented cups in total trapeziometacarpal joint prostheses.
      aug:
        au:
          Hansen, Torben Bæk
          Stilling, Maiken
        affil: Department of Orthopaedics, Section of Hand Surgery, and Orthopaedic Research Unit, Holstebro Regional Hospital, Holstebro, Denmark.
      sug:
        subj:
          Arthroplasty, Replacement Methods
          Thumb Surgery
          Radiostereometric Analysis
          Human
          Random Assignment
          Prospective Studies
          Descriptive Statistics
          Data Analysis Software
          Male
          Female
          Adult
          Middle Age
          Aged
          Tomography, X-Ray Computed
          Visual Analog Scaling
          T-Tests
          Mann-Whitney U Test
          Wilcoxon Signed Rank Test
          Fisher's Exact Test
          Confidence Intervals
          Wilcoxon Rank Sum Test
          Questionnaires
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background and purpose Cup failure is a recognized problem in total trapeziometacarpal (TM) joint prostheses; it may be related to poor fixation, which can be revealed by radiostereometric analysis (RSA). We compared the early implant migration of cemented trapezium cups to that of uncemented screw cups. Patients and methods In a prospective, parallel-group, randomized patient-blinded clinical trial, we included 32 hands in 28 patients (5 males) with a mean age of 58 (40-77) years and with Eaton stage-2 or -3 osteoarthritis of the trapeziometacarpal joint. Patients were randomized to surgery with a cemented DLC all-polyethylene cup (C) (n = 16) or an uncemented hydroxyapatite-coated chrome-cobalt Elektra screw cup (UC) (n = 16). Uncemented cups were inserted without threading of the bone. Stereoradiographs for evaluation of cup migration (primary effect size) and DASH and pain scores were obtained during 2 years of follow-up. Results The 2-year total translation (TT) was similar (p = 0.2): 0.24 mm (SD 0.10) for the C (n = 11) and 0.19 mm (SD 0.16) for the UC (n = 11). Variances were similar (p = 0.4). Judged by RSA, 2 UC cups and 1 C cup became loose (TT > 1 mm). Both UC cups were found to be loose at revision. Grip strength, pain, and DASH scores were similar between groups at all measurement points. Interpretation Early implant fixation and clinical outcome were equally good with both cup designs. This is the first clinical RSA study on trapezium cups, and the method appears to be clinically useful for detection of loose implants.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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