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J Wrist Surg
DOI: 10.1055/s-0044-1779498
Scientific Article

Comparative Analysis of Two Hemiarthroplasty Techniques for Symptomatic Distal Radial Ulnar Joint Arthritis

Nathan Hebel
1   Mayo Clinic Alix School of Medicine, Rochester, Minnesota
,
Kitty Y. Wu
2   Division of Orthopedic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
3   Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
Elizabeth Helsper
2   Division of Orthopedic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
Bassem El Hassan
2   Division of Orthopedic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
Sanjeev Kakar
2   Division of Orthopedic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
Marco Rizzo
2   Division of Orthopedic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
Steven L. Moran
2   Division of Orthopedic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
3   Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
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Abstract

Background Hemiarthroplasty may be indicated for patients with distal radioulnar joint (DRUJ) arthritis. Recently, the use of the pyrocarbon metacarpophalangeal implant has been proposed as a novel means of treating DRUJ arthritis due to the materials improved mechanical properties and wear characteristics.

Purpose and Questions This study compares midterm outcomes of metallic and pyrocarbon hemiarthroplasties for the treatment of symptomatic DRUJ arthritis. Questions of interest included outcomes and complications.

Patients and Methods In total, 32 hemiarthroplasties, 10 metallic and 22 pyrocarbon, were performed between 2010 and 2020 by three surgeons at one tertiary medical center. Patients' retrospective outcomes were extracted from the electronic medical record.

Results Postoperatively, the metallic implant group (mean follow-up: 38 months) demonstrated decreased pain but no changes in range of motion. Comparatively, the pyrocarbon group experienced an improved range of motion and postoperative pain (p < 0.05). Radiographic analysis demonstrated 10% of metallic implants and 9% of pyrocarbon implants to have resulted in thinning of the lateral cortex of the radius at the final follow-up. Minor complications in metallic and pyrocarbon implant groups warranting reoperation occurred at rates of 10 and 13.5% while implant failure occurred at a rate of 30 and 18%, respectively.

Discussion Within this study, pyrocarbon implants resulted in significant functional improvement with comparable complication and failure rates to the metallic implant. Long-term stability demonstrated efficacy for both techniques in symptomatic DRUJ treatment.

Type of Study/Level of Evidence Observational Case Series IV.

Keywords

hemiarthroplasty - distal radioulnar joint - pyrocarbon - wrist

Note

S.L.M. is a consultant for Smith and Nephew.


All presented work is in accordance with the Mayo Clinic Institutional Review Board.




Publication History

Received: 05 August 2023

Accepted: 09 January 2024

Article published online:
31 January 2024

© 2024. Thieme. All rights reserved.

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