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A-0553 Mechanisms of failure in base of thumb implant arthroplasty: A Systematic Review
David J Hunter-Smith
Friday, June 15, 2018 · 5:52 p.m. · 06m 48s
David J Hunter-Smith, Dasun Ganhewa, Rui Wu, Michael P Chae, Vicky Tobin, Warren M Rozen 1. Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, 2 Hastings Road, Frankston Victoria 3199 Australia. 2. Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199 Australia
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on on on on thank you
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ah
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all uh thank you very much i'm tempted to to uh spec to buy a a lot was present some of the work
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on the complications associated with the use of implant biased uh
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treatments devices some i thought us they're not to disclose
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so the symptoms and management of basil some arthritis uh well nine to us all
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you know it's tried and true basically possum on a sell out to
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alice the most commonly used percentage of the very few implants used
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with regard to implants there's a bewildering right yeah yeah but many potential benefits the shoes for
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us in the striker is was to understand the favourites associated with the use of implants
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the purpose of doing this review was too i with the design of the new to pace you implied
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id that we have and the object objectives were to determine the for the rights
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of currently available implants another the father complications leading to implant file there
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we use the uh pressman got line somewhat restricted to
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english language studies we use typical a methodology in
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for this study
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with regard to screening we particularly focused um on salvage
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an additional procedures high every operation rectify that
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a flow chart mood from i don't know i do studies ten two hundred and twenty five included studies
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the most frequent level all evidence was level for we ah the thought of a
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five thousand passions and implants now with the main followup of fifty nance
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implying grades were divided into a great using the telly classification system
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the revision rights we calculated firstly paw calculating imply he is
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on not multiply number bottle plastics bottom mainland to follow
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the ten year vision right was to rot as a number of ah as the number
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of the revised to pertain imply he is which was then expressed as a percentage
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as an example using the this method that can you revision right to total tool replacement was twenty four percent
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which can be interpreted as head of the total hundred your place
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was twenty four hour of the last ten years post op
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so as you can say the revision right so the groups was generally high
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it's a very on the y. axis represents what the
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real skinny complication keys to the revision right
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as an example into position with total to pay zero section
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has an overall tenure vision right of seventeen percent
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with twenty percent of those implants with complications leading to revision
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he we have the complications which lay to implant file to the waiting complications where i septic loosening
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dislocation and persistent kind the size of the c. is
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represent the proportion of patients with the complication
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the y. axis it's a proportional passions we've was due the complication
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for example
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well two balls
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for example the ten you can plant for your actually derisively glistening was i to say it
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it's a common complication and because this the years relatively ledge
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it is of the complication because i didn't set of patients with my setting loosening require vision
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so what does this main in the real world setting and
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had we benchmark the role of implants against other forms
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so we went on to have a look at the rights revision for to basically plus minus the lottery on
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we used to sign sort of methodology for the non implant priced reconstruction
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as you can say the revision rights or maybe only saying to
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be low uh but not as for implant battery constructions
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currently there are no i've got no answer acceptable unacceptable fire right so we applied one of
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the screening criteria employed body astride of pick joint registry
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to identify implants with all fight for your rights
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and that got line is that any implanted exceeds twice the overall fire right for that group so the group with the
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lowest for the right is too busy acting uh plus monticello t. on the rights to two point four percent
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so twice of that for the ride is four point i percent
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and if the dream by some some implants work uh
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subjected to that to add to this uh this registry and
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then that would be a trigger for a an investigation
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so when we apply the writer for half open data set is cut off
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we can say the majority re implant priced options of fire rights
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hi haven't parts that are not inclined but priced priced uh options with a
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handful of implied implantable of four point i sent a cut off
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so uh uh the conclusions from a review was that most
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intensify their rights hard the non implant take next
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it would be very good to it uh to establish unacceptable benchmark for him packing plant for them
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uh using a joint applies to registry as with that might not be appropriate in that setting
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but i'm dedicated and implant registries would be useful
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the level of evidence for platters i'll force that after classes
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can be improved by prospective studies which accounted thing down
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and uh we think that this review can ideas to design and and you implied to move forward thank you
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how very interesting any question
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from the audience
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i have a question or just one remark a registry and um
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uh aspect of studies i think the best randomised control
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try or is the message registry registry is the most objective thing
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you can have to make sure that your your impart
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on on implant works on now there's too many conflicts of interest otherwise yeah and did you have any um
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each dependency regarding your failure of your troubles me
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so an implant did you have any each dependency regard with twenty four percent of implants that failed
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i mean was it each dependence or was it i mean we actually didn't we didn't look at that we didn't job and
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that had we we probably could but uh 'cause that would be
