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CC BY-NC-ND 4.0 · J Wrist Surg 2025; 14(02): 134-143
DOI: 10.1055/s-0044-1779448
Scientific Article

Aptis Distal Radioulnar Joint Implant: Management of Remarkable Complications

Shirley D. Stougie   *
1   Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
2   Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
,
Frederique M. Kemme   *
1   Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
,
J. Henk Coert
2   Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
,
Joris G. M. Oonk
3   Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
,
Lara Plugge
1   Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
,
Margriet H. M. van Doesburg
1   Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
› Author Affiliations Funding None.
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Abstract

Background The aim of an Aptis distal radioulnar joint (DRUJ) implant is to reconstruct the DRUJ in patients with a destroyed, painful DRUJ, and gross ulnar instability. The literature is scarce regarding the management of (severe) early complications related to the Aptis implant in wrists with more rare conditions, such as rheumatoid arthritis, congenital malformations, or leiomyosarcoma of the distal ulna.

Purpose This paper describes the clinical results, (severe) early complications related to the implant, revision surgery, patient satisfaction with the revision surgery, and esthetic appearance of the affected wrist in this specific cohort.

Materials and Methods Retrospective evaluation of five consecutive patients with a short-to-medium follow-up time of 32 months (range: 18–53 months) was carried out.

Results The follow-up revealed implant osseointegration failure in two cases, periprosthetic fractures in two cases, and acute carpal tunnel syndrome in one case. Three Aptis DRUJ arthroplasties were converted into a proximal Darrach. In four cases (80%), the patient was satisfied with the revision surgery due to pain reduction. In four cases (80%), the esthetic appearance of the affected wrist was found disappointing.

Conclusion This study describes remarkable complications related to the Aptis implants in wrists with more rare conditions. The implant is more likely to fail in wrists with poor bone stock, remodeling of the radius, deformation, and malformation of the radius. The range of indications for the usage of the implant to maintain wrist function may be strict.

Level of Evidence IV.

Keywords

Aptis - distal radioulnar joint - arthroplasty - rheumatoid arthritis - congenital malformations - complications

Authors' Contributors

All named authors were actively involved in the planning, enactment, and writing up of the study.


Ethical Approval

Approval of the Medical Ethical Committee of the Amsterdam University Medical Center, the Netherlands.


Patient's Consent

Written informed consent was obtained from a legally authorized representative (s) for anonymized patient information to be published in this article.


* Both authors contributed equally to the manuscript.




Publication History

Received: 19 June 2023

Accepted: 09 January 2024

Article published online:
02 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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