Abstract：
OBJECTIVE: We developed a semiconstrained total wrist prosthesis that was used in a series of patients with rheumatoid arthritis. We previously reported favorable clinical outcomes for up to 5 years after surgery; however, the longer-term outcomes remain unclear. The objective of this study was to evaluate the clinical outcomes of this wrist prosthesis for the treatment of severe wrist rheumatoid arthritis during a minimum 10 years of follow-up.
METHODS: From 2010 through 2012, total wrist arthroplasty using the semiconstrained total wrist arthroplasty device was performed in 20 wrists in 20 patients with rheumatoid arthritis (five men and 15 women). The mean patient age was 64 years (range, 50-84 years). Preoperative radiographs showed Larsen grade IV changes in 16 wrists and grade V changes in four wrists. Patients were evaluated clinically and radiologically before surgery, 5 years after surgery, and 10 years or more after surgery. Evaluated parameters were the visual analog scale for pain, range of motion, Figgie score, and Disabilities of the Arm, Shoulder, and Hand score.
RESULTS: The minimum 10-year follow-up clinical results (mean, 11.3 years) were available for all 14 surviving patients (three men and 11 women). Significant improvements in the mean visual analog scale for pain, Figgie score, and Disabilities of the Arm, Shoulder, and Hand score, compared with those before surgery, were maintained from 5 years after surgery to the final follow-up. The mean wrist flexion angle tended to slightly decrease at 5 years after surgery compared with that before surgery but remained similar from 5 years after surgery to the final follow-up. The increase in the mean wrist extension angle, compared with that before surgery, was maintained from 5 years after surgery to the final follow-up. Radiographic evaluation had already revealed implant loosening in five of the 19 wrists at 5 years after surgery, but there were no new cases of component loosening identified at the final follow-up.
CONCLUSIONS: Total wrist arthroplasty using the semiconstrained arthroplasty system achieves favorable clinical outcomes with no serious complications requiring revision for 10 years after surgery.
METHODS: Therapeutic IV.
METHODS: From 2010 through 2012, total wrist arthroplasty using the semiconstrained total wrist arthroplasty device was performed in 20 wrists in 20 patients with rheumatoid arthritis (five men and 15 women). The mean patient age was 64 years (range, 50-84 years). Preoperative radiographs showed Larsen grade IV changes in 16 wrists and grade V changes in four wrists. Patients were evaluated clinically and radiologically before surgery, 5 years after surgery, and 10 years or more after surgery. Evaluated parameters were the visual analog scale for pain, range of motion, Figgie score, and Disabilities of the Arm, Shoulder, and Hand score.
RESULTS: The minimum 10-year follow-up clinical results (mean, 11.3 years) were available for all 14 surviving patients (three men and 11 women). Significant improvements in the mean visual analog scale for pain, Figgie score, and Disabilities of the Arm, Shoulder, and Hand score, compared with those before surgery, were maintained from 5 years after surgery to the final follow-up. The mean wrist flexion angle tended to slightly decrease at 5 years after surgery compared with that before surgery but remained similar from 5 years after surgery to the final follow-up. The increase in the mean wrist extension angle, compared with that before surgery, was maintained from 5 years after surgery to the final follow-up. Radiographic evaluation had already revealed implant loosening in five of the 19 wrists at 5 years after surgery, but there were no new cases of component loosening identified at the final follow-up.
CONCLUSIONS: Total wrist arthroplasty using the semiconstrained arthroplasty system achieves favorable clinical outcomes with no serious complications requiring revision for 10 years after surgery.
METHODS: Therapeutic IV.
摘要：
目的：我们开发了一种半约束的全腕关节假体，用于一系列类风湿关节炎患者。我们以前报道了手术后5年的良好临床结果；然而，长期结局仍不清楚.这项研究的目的是评估这种腕关节假体在至少10年的随访中治疗严重腕关节类风湿性关节炎的临床效果。
方法：从2010年到2012年，在20名类风湿性关节炎患者（5名男性和15名女性）的20个手腕中使用半约束式全腕关节成形术装置进行了全腕关节成形术。患者平均年龄为64岁(范围，50-84岁）。术前X光片显示，16个手腕的LarsenIV级变化和四个手腕的V级变化。手术前对患者进行了临床和放射学评估，手术后5年,手术后10年或更长时间。评估的参数是疼痛的视觉模拟量表，运动范围,菲吉得分，和手臂的残疾，肩膀,手得分。
结果：最低10年随访临床结果（平均值，11.3年）适用于所有14名存活患者（3名男性和11名女性）。疼痛的平均视觉模拟量表显著改善，菲吉得分，和手臂的残疾，肩膀,和手得分，与手术前相比，从手术后5年到最后一次随访。与手术前相比，手术后5年的平均腕关节屈曲角度倾向于略有下降，但从手术后5年到最后一次随访保持相似。平均手腕伸展角度的增加，与手术前相比，从手术后5年到最后一次随访。影像学评估已经显示，手术后5年的19个手腕中有5个出现植入物松动，但在最后的随访中没有发现新的部件松动病例.
结论：使用半约束关节置换系统的全腕关节置换取得了良好的临床效果，没有严重的并发症，需要在术后10年内进行翻修。
方法：治疗IV。
方法：从2010年到2012年，在20名类风湿性关节炎患者（5名男性和15名女性）的20个手腕中使用半约束式全腕关节成形术装置进行了全腕关节成形术。患者平均年龄为64岁(范围，50-84岁）。术前X光片显示，16个手腕的LarsenIV级变化和四个手腕的V级变化。手术前对患者进行了临床和放射学评估，手术后5年,手术后10年或更长时间。评估的参数是疼痛的视觉模拟量表，运动范围,菲吉得分，和手臂的残疾，肩膀,手得分。
结果：最低10年随访临床结果（平均值，11.3年）适用于所有14名存活患者（3名男性和11名女性）。疼痛的平均视觉模拟量表显著改善，菲吉得分，和手臂的残疾，肩膀,和手得分，与手术前相比，从手术后5年到最后一次随访。与手术前相比，手术后5年的平均腕关节屈曲角度倾向于略有下降，但从手术后5年到最后一次随访保持相似。平均手腕伸展角度的增加，与手术前相比，从手术后5年到最后一次随访。影像学评估已经显示，手术后5年的19个手腕中有5个出现植入物松动，但在最后的随访中没有发现新的部件松动病例.
结论：使用半约束关节置换系统的全腕关节置换取得了良好的临床效果，没有严重的并发症，需要在术后10年内进行翻修。
方法：治疗IV。
