Distal radioulnar joint kinematics before surgery and 12 months following open foveal reinsertion of the triangular fibrocartilage complex: comparison with the contralateral non-injured joint.
Background and purpose -- Foveal triangular fibrocartilage complex (TFCC) lesion may cause distal radioulnar joint (DRUJ) instability. Dynamic radiostereometry (dRSA) has been validated for objective measurement of DRUJ kinematics. We evaluated DRUJ kinematics by dRSA before surgery and 12 months fo...
| Publicado en: | Acta Orthopaedica Vol. 93; pp. 574 - 583 |
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| Autores principales: | , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=162614219&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 162614219 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: 2022 vid: 93 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 162614219 162614219 162614219 10.2340/17453674.2022.3141 162614219 ppf: 574 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Distal radioulnar joint kinematics before surgery and 12 months following open foveal reinsertion of the triangular fibrocartilage complex: comparison with the contralateral non-injured joint. aug: au: THILLEMANN, Janni K. DE RAEDT, Sepp PETERSEN, Emil T. affil: Department of Orthopaedics, University Clinic for Hand, Hip and Knee Surgery, Gødstrup Hospital, Herning sug: subj: Kinematics Evaluation Joint Instability Surgery Wrist Joint Pathology Cartilage Surgery Radiostereometric Analysis Perioperative Care Human Male Female Adult Middle Age Pain Management Methods Comparative Studies Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background and purpose -- Foveal triangular fibrocartilage complex (TFCC) lesion may cause distal radioulnar joint (DRUJ) instability. Dynamic radiostereometry (dRSA) has been validated for objective measurement of DRUJ kinematics. We evaluated DRUJ kinematics by dRSA before surgery and 12 months following open foveal reinsertion of the TFCC in comparison with contralateral non-injured DRUJs. Patients and methods -- In a prospective cohort study, 21 patients (11 men) of mean age 34 years (22--50) with arthroscopically confirmed foveal TFCC lesion were evaluated preoperatively, and at 6 and 12 months after open foveal TFCC reinsertion with QDASH, PRWE, pain on NRS, and bilateral dRSA imaging during a patient active press test motion cycle, including a force-loaded downstroke and a release phase. Results -- Preoperatively, the force-loaded part (> 2.3 kg; 95% CI 1.6--3.0) of the press test motion cycle (from 15% to 75%) revealed a more volar position of the ulnar head in the sigmoid notch (DRUJ position ratio) and increased distance in DRUJs with foveal TFCC lesion compared with the patients' contralateral non-injured DRUJ (p < 0.05). 6 months postoperatively, the DRUJ position was generally normalized and remained normalized at 12 months. However, the DRUJ distance remained higher on the injured side. 12 months postoperatively, patients reported less pain during activities, with improved QDASH and PRWE scores (p < 0.007). Interpretation -- DRUJ kinematics during the press test showed increased DRUJ translation to a more volar position of the ulnar head after foveal TFCC lesion compared with the contralateral non-injured DRUJs. Open foveal TFCC reinsertion had a stabilizing effect on DRUJ kinematics towards normalization, and improved patient-reported outcomes 6 and 12 months after surgery. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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