Abstract:
We reviewed the incidence and management of complications after total wrist arthroplasty, as reported in the literature, with so-called fourth-generation implants and other recent designs. While early intraoperative and postoperative complications, including fractures, tendon lacerations, infection, nerve compression, tendonitis, stiffness and chronic regional pain syndrome, had an acceptable incidence, late complications, such as periprosthetic osteolysis and implant loosening, occurred more frequently. Implant survival at 10 years was in the range of 70%-80% in most publications. Several of the implants have been modified or withdrawn. Instability and dislocation were frequent after a pyrocarbon spacer. Failed arthroplasties can be salvaged by revision arthroplasty or total wrist arthrodesis. Revision arthroplasty has a lower survival rate than primary arthroplasty and does not clearly offer important significant advantages over total wrist arthrodesis in terms of patient-reported outcome measures. Further development of prosthetic design, new materials and more knowledge on patient-related risk factors are needed.
摘要:
我们回顾了全腕关节置换术后并发症的发生率和处理,正如文献报道的那样,所谓的第四代植入物和其他最近的设计。而术中和术后早期并发症,包括骨折,肌腱撕裂,感染,神经压迫,肌腱炎,僵硬和慢性区域疼痛综合征,有一个可以接受的发生率,晚期并发症,如假体周围骨质溶解和植入物松动,发生得更频繁。在大多数出版物中,10年的植入物存活率在70%-80%的范围内。一些植入物已被修改或撤回。热解碳间隔物后经常发生不稳定性和位错。失败的关节置换术可以通过翻修关节成形术或全腕关节固定术来挽救。翻修性关节成形术的存活率低于初次关节成形术,并且在患者报告的结果指标方面,与全腕关节固定术相比,没有明显提供重要的显着优势。假肢设计的进一步发展,需要新的材料和更多关于患者相关危险因素的知识。