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Abstract：
BACKGROUND: Total joint arthroplasty as a surgical treatment option for trapeziometacarpal joint arthritis is recently revived. The aim of this study is to report on mid- and long-term results of the Elektra (single-mobility) and Moovis (dual-mobility) prosthesis for treatment of primary thumb carpometacarpal joint arthritis.
METHODS: In this retrospective, monocentric, descriptive cohort study, 31 prostheses were evaluated that were implanted by a single surgeon in 26 patients between 2009 and 2019. Indication for surgery was trapeziometacarpal joint osteoarthritis (Eaton/Littler Stage II and III). Clinical and radiological follow-up was performed at a minimum of 24 months. The postoperative assessment included range of motion, pain, strength as well as functional scores (DASH, MHQ). Implant survival and complications were the primary endpoints.
RESULTS: 10 Elektra and 21 Moovis prostheses were implanted between 2009 and 2019 with a mean follow-up of 74.2 months in the Elektra and 41.4 months in the Moovis group. The average patients\' age at surgery was 64 years. Postoperative pain levels (VAS 0-10) were below 2 at rest and under stress in both groups. Grip/pinch strength and range of motion showed results comparable to the contralateral hand. Opposition was excellent with an average Kapandji index of 9.6 in both groups. Elektra achieved slightly better functional scores in the DASH and MHQ score. Satisfaction was high in both groups, and 96% of the patients would recommend the procedure. Metacarpophalangeal hyperextension > 15° was seen in 3 patients per group preoperatively and was corrected to < 5° post-surgery. 3 Elektra prostheses were revised due to cup loosening and dislocation for cup and/or neck replacement or secondary trapeziectomy. 1 Moovis prosthesis was revised with an exchange of the neck to a larger size due to restricted movement. After the mean follow-up of 7.9 years in Elektra and 3.5 years in MOOVIS, cumulative survival was 68.6% vs. 95.2%, respectively.
CONCLUSIONS: In this mid- to long-term retrospective analysis, total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function. Patient satisfaction is overall high. While revision due to cup loosening occurred more often in patients with single-mobility implants, no cases of dislocation or loosening of components were observed in the dual-mobility group.
BACKGROUND: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Medical Faculty of Heidelberg University, reference number S-150/2020.
METHODS: In this retrospective, monocentric, descriptive cohort study, 31 prostheses were evaluated that were implanted by a single surgeon in 26 patients between 2009 and 2019. Indication for surgery was trapeziometacarpal joint osteoarthritis (Eaton/Littler Stage II and III). Clinical and radiological follow-up was performed at a minimum of 24 months. The postoperative assessment included range of motion, pain, strength as well as functional scores (DASH, MHQ). Implant survival and complications were the primary endpoints.
RESULTS: 10 Elektra and 21 Moovis prostheses were implanted between 2009 and 2019 with a mean follow-up of 74.2 months in the Elektra and 41.4 months in the Moovis group. The average patients\' age at surgery was 64 years. Postoperative pain levels (VAS 0-10) were below 2 at rest and under stress in both groups. Grip/pinch strength and range of motion showed results comparable to the contralateral hand. Opposition was excellent with an average Kapandji index of 9.6 in both groups. Elektra achieved slightly better functional scores in the DASH and MHQ score. Satisfaction was high in both groups, and 96% of the patients would recommend the procedure. Metacarpophalangeal hyperextension > 15° was seen in 3 patients per group preoperatively and was corrected to < 5° post-surgery. 3 Elektra prostheses were revised due to cup loosening and dislocation for cup and/or neck replacement or secondary trapeziectomy. 1 Moovis prosthesis was revised with an exchange of the neck to a larger size due to restricted movement. After the mean follow-up of 7.9 years in Elektra and 3.5 years in MOOVIS, cumulative survival was 68.6% vs. 95.2%, respectively.
CONCLUSIONS: In this mid- to long-term retrospective analysis, total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function. Patient satisfaction is overall high. While revision due to cup loosening occurred more often in patients with single-mobility implants, no cases of dislocation or loosening of components were observed in the dual-mobility group.
BACKGROUND: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Medical Faculty of Heidelberg University, reference number S-150/2020.
摘要：
背景：全关节成形术作为一种治疗梯形掌骨关节关节炎的手术选择最近得到了恢复。这项研究的目的是报告Elektra（单移动性）和Moovis（双移动性）假体治疗原发性拇指腕掌关节炎的中长期结果。
方法：在本回顾性研究中，单心,描述性队列研究，评估了2009年至2019年期间由一名外科医生在26例患者中植入的31个假体。手术适应症是梯形掌骨关节骨关节炎（伊顿/利特勒II期和III期）。临床和放射学随访至少24个月。术后评估包括活动范围，疼痛,强度和功能分数(DASH，MHQ）。植入物生存和并发症是主要终点。
结果：在2009年至2019年之间植入了10个Elektra和21个Moovis假体，Elektra组的平均随访时间为74.2个月，Moovis组的平均随访时间为41.4个月。手术患者的平均年龄为64岁。两组在休息和压力下的术后疼痛水平（VAS0-10）均低于2。握力/捏力和运动范围显示出与对侧手相当的结果。两组的反对派表现优异，平均Kapandji指数为9.6。Elektra在DASH和MHQ评分中获得了略好的功能评分。两组的满意度都很高，96%的患者会推荐该手术。术前每组3例患者的掌指过伸>15°，术后校正至<5°。3个Elektra假体由于杯松动和脱位而进行了杯和/或颈部置换或二次梯形切除术。1Moovis假体由于运动受限而将颈部更换为更大的尺寸。在Elektra和MOOVIS平均随访7.9年和3.5年后，累积生存率为68.6%vs.95.2%,分别。
结论：在这项中长期回顾性分析中，原发性梯形掌骨关节炎的全关节置换术导致疼痛程度低，良好的流动性和临床功能。患者满意度总体较高。虽然由于杯体松动导致的翻修更常见于单活动植入物的患者，在双移动性组中未观察到组件脱位或松动的病例。
背景：这项研究是根据《赫尔辛基宣言》进行的，并经海德堡大学医学院伦理委员会批准，参考编号S-150/2020。
方法：在本回顾性研究中，单心,描述性队列研究，评估了2009年至2019年期间由一名外科医生在26例患者中植入的31个假体。手术适应症是梯形掌骨关节骨关节炎（伊顿/利特勒II期和III期）。临床和放射学随访至少24个月。术后评估包括活动范围，疼痛,强度和功能分数(DASH，MHQ）。植入物生存和并发症是主要终点。
结果：在2009年至2019年之间植入了10个Elektra和21个Moovis假体，Elektra组的平均随访时间为74.2个月，Moovis组的平均随访时间为41.4个月。手术患者的平均年龄为64岁。两组在休息和压力下的术后疼痛水平（VAS0-10）均低于2。握力/捏力和运动范围显示出与对侧手相当的结果。两组的反对派表现优异，平均Kapandji指数为9.6。Elektra在DASH和MHQ评分中获得了略好的功能评分。两组的满意度都很高，96%的患者会推荐该手术。术前每组3例患者的掌指过伸>15°，术后校正至<5°。3个Elektra假体由于杯松动和脱位而进行了杯和/或颈部置换或二次梯形切除术。1Moovis假体由于运动受限而将颈部更换为更大的尺寸。在Elektra和MOOVIS平均随访7.9年和3.5年后，累积生存率为68.6%vs.95.2%,分别。
结论：在这项中长期回顾性分析中，原发性梯形掌骨关节炎的全关节置换术导致疼痛程度低，良好的流动性和临床功能。患者满意度总体较高。虽然由于杯体松动导致的翻修更常见于单活动植入物的患者，在双移动性组中未观察到组件脱位或松动的病例。
背景：这项研究是根据《赫尔辛基宣言》进行的，并经海德堡大学医学院伦理委员会批准，参考编号S-150/2020。
