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A-0416 Short to intermediate results of the Motec total wrist arthroplasty
Duncan McGuire
Friday, June 15, 2018 · 3:35 p.m. · 06m 23s
Edwin Ooms 1, Duncan McGuire 2, Tim Sluis-Cremer 2, Michael Solomons 2 1 Centre for Orthopaedic Surgery OCON, Hand and Wrist unit, Hengelo, The Netherlands; 2 Martin Singer Hand Unit, Groote Schuur Hospital, University of Cape Town, South Africa
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the main um and don't require presenting work prior to ninety was one of
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our fellows that um we could is gospel in cape town south africa
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uh we've got no declarations except at the scene of the march solomon's the plate consultant for us we mac
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so the management of in stage read a couple of properties involving challenge
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causal mostly inflammatory arthritis from a oh a post traumatic oh
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a snack and slack wrist and con box disease
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so if we look at the evolution of treatment of ten call plot rightist terrorist fusion of being perform for years
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it offers a permanent pain free solution it sacrifices motion and and therefore decreases function
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and it's been the profit procedure and is for much more common even a turtle wrist upright replacement
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so a title wrist replacements also offers a pain free solution but it maintains the
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range of motion and probably offers the patient data function and data satisfaction
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so there's several designs out the the one on the left is the universal too
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one on the right to uh the one in the middle is the by x. which we fade is being taken off the market
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and the one on the right is the remission all these designs of got an ellipsoid articulation
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designed to replicate the just the radius articulates surface in a more anatomical why
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so the my take is that different it's a ball and socket articulation the stains or titanium
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which are could lost it to um uh up to my as a also disintegration
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articulation cans into choices of uh make one battle cry about
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couple crime one metal i'm hit with a pickup
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so the study with the director of spectre review of a lot tighter
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wrist wrist wrist replacements with a minimum of one year follow up
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the two surgeons in three sentences and the rest we assist the pain using of zero and
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alex kyle the looked at function with a quick dash unpaid action related wrist evaluation
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look to the right idea radiological outcomes and the complications and revision surgery
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so the surgical technique we do it also ligaments sparing approach the proximal rise excised
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we do not fused with the h. c. m. c. joint which is what's described
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in the surgical technique we feel that by exercising that joint um you
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did you change you gonna be left to the non union they which could uh cause problems further down the line
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we feel that there's very little motion they already in what you pause that big distal components go across
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that the motion is gonna be negligible and we haven't had any complications all problems this uh for
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so starting point is to lose started also kept side which helps us get
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the the card want down the central that it made a couple soft
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approximately we go slightly older to this into the radius which is slightly
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different to the describe surgical technique we find this um allows more
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anatomical alignment of the rest of the third medical blink appetite of the net force of the distal radius
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so we we had twenty five person twenty three patients means followup was thirty nine months mean age
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of fifty seven yes um most of our patients
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or rheumatoid arthritis yet far converts disease
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force force next one slack to probably o. a. and one post traumatic away
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i mean dash quick test scores thirty nine the mean p. audibly us forty one
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and uh i mean visual analogue line school was was three might look at these
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uh i mean there's also that quick passionately audibly integrate quite high but
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remember the majority of operations were remit toward passion so they already starting from
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the bad based on what would probably pine another function in a sense
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i mean all caught motion full flexion extension was seventy three degrees
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the mean radio only deviation or course thirty nine degrees
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for the radiological assessment we looked at the long it's imposition of the
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proximal and distal components and specifically on that just a component we
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wanna chill we look to fill the top of the implied was costly
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business and we look for substance you see listening instruct shielding
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so we found three components at the still loosening you can see
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the around the distal component is a high low indicating listening
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two of these rice into magic one was symptomatic with pain and that
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that patient to look for revision in the next few weeks
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we had one case of stray shielding the extra on the left is shortly after surgery in in extra on the right is it three years
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and there's a lot of binary absorption around the articulation but the sclerosis of that just a radius and there's no
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use in c. around the stems indicating that the prosthesis is the low fixed and this patient is something free
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you know the case of sepsis notifications no possible component listening and just those
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three just to come on and these things which i just discussed
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i just wanna mention one case which we did not include in the study this patient
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was lost to follow up shortly after a vision and is total serious follows title thomas was less than one
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year so we didn't include him use one of the phase cases we did and we did a small
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making a fifteen minute meeting it on him he was a revised it three months teach impinge meant
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and then shortly after revision use last fall out say was not included in the study
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but after this the surgical technique is being changed and now it's
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a recognised problem with that in plot that if you use
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fifteen millimetre hate and a small neck you will get impatient which is now you can see on the picture below safe you jane
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these cases never do that combination of small neck and fifteen million yeah it
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so in conclusion we we showing good results of the my tractor to raise the minimum of one year follow up
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and fey takes in quick dash p. although we and the ace course the local complication
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right with twelve percent just listening well this could probably be be prevented by
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putting the just the component parts business we feel although not of the components
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that will well that did not have just loose listing will cost business
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there's ninety six percent of all that thirty nine months the guy's one revision
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is booked for the next week and there's a low vision right
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A-0416 Short to intermediate results of the Motec total wrist arthroplasty
Duncan McGuire
June 15, 2018 · 3:35 p.m.
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