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Aktuelle Rheumatologie 2014; 39(02): 100-105
DOI: 10.1055/s-0033-1355376
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Handgelenksprothese

Total Wrist Arthroplasty
A. Wanivenhaus
1   Department of Orthopedics, Medizinische Universität, Wien, Österreich
› Author Affiliations
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Publication History

Publication Date:
21 October 2013 (online)

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Zusammenfassung

Destruierte, instabile Handgelenke stellen eine therapeutische Herausforderung dar, die durch Teil- oder komplette Handgelenksarthrodesen sowie durch Endoprothese versorgbar sind. Die Wiederherstellung von karpaler Höhe und Stabilität kann durch sämtliche Verfahren erzielt werden; die nahezu vollständige Handgelenksmobilität nur durch die Handgelenksendoprothese. Die bereits jahrzehntelange Erfahrung mit den Prothesen zeigt vor allem eine Abrieb bedingte Lysebildung, Migration und teilweise Design abhängig auch Luxation als Komplikationen auf. Die Komplikationsrate ist hoch und mit der Implantatsionsdauer zunehmend, sodass diese Implantate in der Regel eine Zwischenlösung darstellen, die nur bei Vorliegen einer individuellen Indikationsnotwendigkeit verwendet werden sollten. Die Revision einer gelockerten Handgelenksendoprothese ist durch Beckenkammspan und Osteosynthese in eine Arthrodese möglich und in hohem Maße erfolgreich.

Abstract

Damaged, unstable wrists represent a therapeutic challenge, which can be managed by partial or complete arthrodeses of the wrist and by arthroplasty. The restoration of carpal height and stability can be achieved by all methods, the nearly complete wrist mobility only by the wrist joint implant. The decades-long experience with the wrist arthroplasty mainly reflects abrasion of the polyethylene, migration and is partially dependent on the design as well as dislocation complications. The complication rate is increasingly high with duration of follow-up, so that these implants generally represent an intermediate solution that should be used only when there is a need for individual indications. The revision of a loose wrist arthroplasty with bone graft and internal fixation for secondary arthrodesis is possible and successful to a large extent.

Schlüsselwörter

Handgelenksendoprothese - Handgelenksinstabilität - Handgelenksdestruktion - Handgelenksrekonstruktion - rheumatische Handgelenksveränderung

Key words

total wrist arthroplasty - wrist instability - wrist destruction - wrist reconstruction - rheumatoid wrist changes
 

  • Literatur

  • 1 Thabe H. Endoprothetische Versorgung des rheumatischen Handgelenkes. Z Rheumatol 2011; 70: 395-399
    CrossrefPubMedGoogle Scholar
  • 2 Swanson AB. Flexible implant arthroplasty for arthritic disabilities of the radiocarpal joint. Ortop Clin Nort Am 1973; 4:: 383
    PubMedGoogle Scholar
  • 3 Nalebuff EA. Factors influencing the results of implant surgery in rheumatoid hand. J Hand Surg 1990; 15B: 395
    PubMedGoogle Scholar
  • 4 Swanson AB, DeGroot Swanson G, Maupin BK. Flexible implant arthroplasty of the radiocarpal joint. Surgical technique and long-term study. Clin Orthop 1984; 187: 94-106
    PubMedGoogle Scholar
  • 5 Brase DW, Millender LH. Failure of silicone rubber wrist arthroplasty in rheumatoid arthritis. J Hand Surg 1986; 11A: 175
    PubMedGoogle Scholar
  • 6 Fatti JF, Palmer AK, Mosher JF. The longterm results of Swanson silcone rubber interpositional wrist arthroplasty. J Hand Surg 1986; 11A: 166-175
    PubMedGoogle Scholar
  • 7 Fatti JF, Palmer AK, Greenkey S et al. Long-term results of Swanson interpositional wrist arthroplasty: Part II. J Hand Surg 1991; 16A: 432-437
    PubMedGoogle Scholar
  • 8 Jolly SL, Ferlic DC, Clayton ML et al. Swanson silicone arthroplasty of the wrist in rheumatoid arthritis: A longterm follow-up. J Hand Surg 1992; 17A: 142-149
    PubMedGoogle Scholar
  • 9 Harboldt SL, Gumley GJ, Balogh K. Osteolysis after silicone arthroplasty. Am J Clin pathol 1992; 98: 594
    PubMedGoogle Scholar
  • 10 Randall T. Surgeons grapple with synovitis, fractures around silicone implants for hand and wrist. JAMA 1992; 13: 268
    PubMedGoogle Scholar
  • 11 Capone RA. The titanium grommet in flexible implant arthroplasty of the radiocarpal joint: a longterm review of 44 cases. Plastic and Rec Surg 1995; 96:: 667-672
    PubMedGoogle Scholar
  • 12 Rosello MI, Costa M, Pizzorno V. Experience of total wrist arthroplasty with silastic implants plus grommets. Clin Orthop 1997; 342: 64-70
    PubMedGoogle Scholar
  • 13 Schill S, Thabe H, Mohr W. Langzeitergebnisse nach Swanson-Prothesenversorgung des rheumatischen Handgelenks. Handchir Mikrochir Plast Chir 2001; 33: 198-206
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Meuli HC. Arthroplastie du poignet. Ann chir 1973; 27: 527-530
    PubMedGoogle Scholar
  • 15 Ferres A, Lluch A, Del Valle m. Universal total wrist arthroplasty: midterm follow-up study. JHS 2011; 36A: 967-973
    PubMedGoogle Scholar
  • 16 Thabe H, Schill S. Die rekonstruktive Versorgung des rheumatischen Handgelenkes mit Handgelenksprothesen. Akt Rheumatol 2009; 34: 38-46
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Lawler EA, Paksima N. Total wrist arthroplasty. Bull NYU Hosp Jt Dis 2006; 64: 98-105
    PubMedGoogle Scholar
  • 18 Radmer S, Andresen R, Sparmann M. Total wrist arthroplasty in pa­tients with rheumatoid arthriotis. J Hand Surg. 2003; 28aA: 795-796
    PubMedGoogle Scholar
  • 19 Rizzo M, Bekenbaugh R. Results of biaxial total wrist arthroplasty with a modified (long) metacarpal stem. J hand Surg 2003; 28A: 577-584
    PubMedGoogle Scholar
  • 20 Rahimtoola ZO, Rozing PM. Preliminary results of total wrist arthroplasty using the RWS Prosthesis. J Hand Surg 2003; 28B: 54-60
    PubMedGoogle Scholar
  • 21 Van harlingen D, Heesterbeek PJC, De Vos MJ. High rate of complications and radiographic loosening of the biaxial total wrist arthroplasty in rheumatoid arthritis. Acta orthopaedica 2011; 82: 721-726
    CrossrefPubMedGoogle Scholar
  • 22 Rizzo M, Beckenbaugh RD. Results of biaxial total wrist arthroplasty with a modified (long) metacarpal stem. J Hand Surg 2003; 28A: 577-584
    PubMedGoogle Scholar
  • 23 Takwale VJ, Nuttall D, Trail IA et al. Biaxial total wrist replacement in patients with rheumatoid arthritis. Clinical review, survivership and radiological analysis. J Bone Joint Surg 2002; 84B: 692-699
    PubMedGoogle Scholar
  • 24 Volz RG. The development of a total wrist arthroplasty. Clin Orthop 1976; 116: 209-214
    PubMedGoogle Scholar
  • 25 Meuli HC. Meuli total wrist arthroplaSty. Clin Orthop 1984; 187: 107-111
    PubMedGoogle Scholar
  • 26 Menon J. Universal total wrist implant: experience with a carpal component fixed with three screws. J Arthroplasty 1998; 13: 515-523
    CrossrefPubMedGoogle Scholar
  • 27 Ferreres A, Lluch A, DelValle M. Universal total wrist arthroplasty: midterm Follow-up study. JHS 2011; 36A: 967-973
    PubMedGoogle Scholar
  • 28 Krukhaug Y, Lie SA, Havelin LI et al. Results of 189 wrist replacements. A Report from the Norwegian Arthroplasty Register. Acta Oretho­paedica 2011; 82:: 405-409
    PubMedGoogle Scholar
  • 29 Beer TA, Turner RH. Wrist arthrodesis for failed wrist implant arthroplasty. JHS 1997; 22A: 685-693
    PubMedGoogle Scholar
  • 30 Lorei MP, Figgie MP, Ranawat CS et al. Clin Orthop 1997; 342: 84-93
    PubMed
  • 31 Ebinger T, Katzmaier P, Wachter NJ et al. Die Rekonstruktion eines Knochendefekts nach Explantation einer Handgelenksendoprothese mit einem vaskularisierten Fibulatransplantat. Unfallchirurg 2003; 106: 172-175
    CrossrefPubMedGoogle Scholar