Medium-term outcomes of the Universal-2 total wrist arthroplasty in patients with rheumatoid arthritis
The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis. This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients...
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| Veröffentlicht in: | The bone & joint journal 2016-12, Vol.98-B (12), p.1642-1647, Article 1642 |
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| creator | Badge, R Kailash, K Dickson, D R Mahalingam, S Raza, A Birch, A Nuttall, D Murali, S R Hayton, M J Talwalkar, S Watts, A C Trail, I A |
| description | The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis.
This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures. Accordingly, 75 patients (85 TWAs) were included in the study. There were 59 women and 16 men with a mean age of 59 years (26 to 86). The mean follow-up was 53 months (24 to 120). Clinical assessment involved recording pain on a visual analogue score, range of movement, grip strength, the Quick Disabilities of the Arm, Shoulder and Hand (DASH) and Wrightington wrist scores. Any adverse effects were documented with particular emphasis on residual pain, limitation of movement, infection, dislocation and the need for revision surgery. Radiographic assessment was performed pre-operatively and at three, six and 12 months post-operatively, and annually thereafter. Arthroplasties were assessed for distal row intercarpal fusion and loosening. Radiolucent zones around the components were documented according to a system developed at our institution.
The mean worst pain was 8.1 (3 to 10) pre-operatively and 5.4 (0 to 10) at latest follow-up (p |
| doi_str_mv | 10.1302/0301-620x.98b12.37121 |
| format | Article |
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This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures. Accordingly, 75 patients (85 TWAs) were included in the study. There were 59 women and 16 men with a mean age of 59 years (26 to 86). The mean follow-up was 53 months (24 to 120). Clinical assessment involved recording pain on a visual analogue score, range of movement, grip strength, the Quick Disabilities of the Arm, Shoulder and Hand (DASH) and Wrightington wrist scores. Any adverse effects were documented with particular emphasis on residual pain, limitation of movement, infection, dislocation and the need for revision surgery. Radiographic assessment was performed pre-operatively and at three, six and 12 months post-operatively, and annually thereafter. Arthroplasties were assessed for distal row intercarpal fusion and loosening. Radiolucent zones around the components were documented according to a system developed at our institution.
The mean worst pain was 8.1 (3 to 10) pre-operatively and 5.4 (0 to 10) at latest follow-up (p < 0.001). Movements were preserved with mean dorsiflexion of 29
(0
to 70
) and palmar flexion of 21
(0
to 50
). The mean grip strength was 4.8 kg (1.7 to 11.5) pre-operatively and 10 kg (0 to 28) at final follow-up (p < 0.001). The mean QuickDASH and Wrightington wrist scores improved from 61 (16 to 91) to 46 (0 to 89) and 7.9 (1.8 to 10) to 5.7 (0 to 7.8) (p < 0.001). A total of six patients (7%) had major complications; three required revision arthroplasty and three an arthrodesis. The Kaplan-Meier probability of survival using removal of the components as the endpoint was 91% at 7.8 years (95% confidence interval 84 to 91).
The Universal-2 TWA is recommended for use in patients with rheumatoid arthritis. Cite this article: Bone Joint J 2016;98-B:1642-7.</description><identifier>ISSN: 2049-4394</identifier><identifier>EISSN: 2049-4408</identifier><identifier>DOI: 10.1302/0301-620x.98b12.37121</identifier><identifier>PMID: 27909126</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid - diagnostic imaging ; Arthritis, Rheumatoid - physiopathology ; Arthritis, Rheumatoid - surgery ; Arthroplasty, Replacement - adverse effects ; Arthroplasty, Replacement - methods ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Joint Prosthesis - adverse effects ; Male ; Middle Aged ; Pain Measurement - methods ; Pain, Postoperative ; Prosthesis Design ; Prosthesis Failure - etiology ; Prosthesis-Related Infections - etiology ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Treatment Outcome ; Wrist Joint - diagnostic imaging ; Wrist Joint - physiopathology ; Wrist Joint - surgery</subject><ispartof>The bone & joint journal, 2016-12, Vol.98-B (12), p.1642-1647, Article 1642</ispartof><rights>2016 The British Editorial Society of Bone & Joint Surgery.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-f7886e89cbba4ed19a993b77017e1598d7468e0fa2afc5baca751a4f8e56e7c3</citedby><cites>FETCH-LOGICAL-c361t-f7886e89cbba4ed19a993b77017e1598d7468e0fa2afc5baca751a4f8e56e7c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27909126$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Badge, R</creatorcontrib><creatorcontrib>Kailash, K</creatorcontrib><creatorcontrib>Dickson, D R</creatorcontrib><creatorcontrib>Mahalingam, S</creatorcontrib><creatorcontrib>Raza, A</creatorcontrib><creatorcontrib>Birch, A</creatorcontrib><creatorcontrib>Nuttall, D</creatorcontrib><creatorcontrib>Murali, S R</creatorcontrib><creatorcontrib>Hayton, M J</creatorcontrib><creatorcontrib>Talwalkar, S</creatorcontrib><creatorcontrib>Watts, A C</creatorcontrib><creatorcontrib>Trail, I A</creatorcontrib><title>Medium-term outcomes of the Universal-2 total wrist arthroplasty in patients with rheumatoid arthritis</title><title>The bone & joint journal</title><addtitle>Bone Joint J</addtitle><description>The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis.
This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures. Accordingly, 75 patients (85 TWAs) were included in the study. There were 59 women and 16 men with a mean age of 59 years (26 to 86). The mean follow-up was 53 months (24 to 120). Clinical assessment involved recording pain on a visual analogue score, range of movement, grip strength, the Quick Disabilities of the Arm, Shoulder and Hand (DASH) and Wrightington wrist scores. Any adverse effects were documented with particular emphasis on residual pain, limitation of movement, infection, dislocation and the need for revision surgery. Radiographic assessment was performed pre-operatively and at three, six and 12 months post-operatively, and annually thereafter. Arthroplasties were assessed for distal row intercarpal fusion and loosening. Radiolucent zones around the components were documented according to a system developed at our institution.
The mean worst pain was 8.1 (3 to 10) pre-operatively and 5.4 (0 to 10) at latest follow-up (p < 0.001). Movements were preserved with mean dorsiflexion of 29
(0
to 70
) and palmar flexion of 21
(0
to 50
). The mean grip strength was 4.8 kg (1.7 to 11.5) pre-operatively and 10 kg (0 to 28) at final follow-up (p < 0.001). The mean QuickDASH and Wrightington wrist scores improved from 61 (16 to 91) to 46 (0 to 89) and 7.9 (1.8 to 10) to 5.7 (0 to 7.8) (p < 0.001). A total of six patients (7%) had major complications; three required revision arthroplasty and three an arthrodesis. The Kaplan-Meier probability of survival using removal of the components as the endpoint was 91% at 7.8 years (95% confidence interval 84 to 91).
The Universal-2 TWA is recommended for use in patients with rheumatoid arthritis. Cite this article: Bone Joint J 2016;98-B:1642-7.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthritis, Rheumatoid - diagnostic imaging</subject><subject>Arthritis, Rheumatoid - physiopathology</subject><subject>Arthritis, Rheumatoid - surgery</subject><subject>Arthroplasty, Replacement - adverse effects</subject><subject>Arthroplasty, Replacement - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hand Strength</subject><subject>Humans</subject><subject>Joint Prosthesis - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain Measurement - methods</subject><subject>Pain, Postoperative</subject><subject>Prosthesis Design</subject><subject>Prosthesis Failure - etiology</subject><subject>Prosthesis-Related Infections - etiology</subject><subject>Range of Motion, Articular</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Wrist Joint - diagnostic imaging</subject><subject>Wrist Joint - physiopathology</subject><subject>Wrist Joint - surgery</subject><issn>2049-4394</issn><issn>2049-4408</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkcFu1DAQhi0EolXpIxT5yCWLx3FiW5ygoqVSEZci9WZNnInWKIkX26Ht25N2tz3AXGYO_3wjfcPYGYgN1EJ-FLWAqpXifmNNB3JTa5Dwih1LoWyllDCvn-faqiN2mvMvsZYRAAresiOprbAg22M2fKc-LFNVKE08LsXHiTKPAy9b4j_n8IdSxrGSvMSCI79LIReOqWxT3I2YywMPM99hCTSXzO9C2fK0pWXCEkO_D4YS8jv2ZsAx0-mhn7Cbi68359-q6x-XV-efrytft1CqQRvTkrG-61BRDxatrTutBWiCxppeq9aQGFDi4JsOPeoGUA2Gmpa0r0_Yhz12l-LvhXJxU8iexhFnikt2YFRjpLIW1mizj_oUc040uF0KE6YHB8I9SnaPkt0q-dZZ8wWke5K87r0_nFi6ifqXrWela-DTP2AfyiooziVhGP_D37unHx7wfwH0zIzJ</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Badge, R</creator><creator>Kailash, K</creator><creator>Dickson, D R</creator><creator>Mahalingam, S</creator><creator>Raza, A</creator><creator>Birch, A</creator><creator>Nuttall, D</creator><creator>Murali, S R</creator><creator>Hayton, M J</creator><creator>Talwalkar, S</creator><creator>Watts, A C</creator><creator>Trail, I A</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201612</creationdate><title>Medium-term outcomes of the Universal-2 total wrist arthroplasty in patients with rheumatoid arthritis</title><author>Badge, R ; Kailash, K ; Dickson, D R ; Mahalingam, S ; Raza, A ; Birch, A ; Nuttall, D ; Murali, S R ; Hayton, M J ; Talwalkar, S ; Watts, A C ; Trail, I A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-f7886e89cbba4ed19a993b77017e1598d7468e0fa2afc5baca751a4f8e56e7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthritis, Rheumatoid - diagnostic imaging</topic><topic>Arthritis, Rheumatoid - physiopathology</topic><topic>Arthritis, Rheumatoid - surgery</topic><topic>Arthroplasty, Replacement - adverse effects</topic><topic>Arthroplasty, Replacement - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hand Strength</topic><topic>Humans</topic><topic>Joint Prosthesis - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain Measurement - methods</topic><topic>Pain, Postoperative</topic><topic>Prosthesis Design</topic><topic>Prosthesis Failure - etiology</topic><topic>Prosthesis-Related Infections - etiology</topic><topic>Range of Motion, Articular</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Wrist Joint - diagnostic imaging</topic><topic>Wrist Joint - physiopathology</topic><topic>Wrist Joint - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Badge, R</creatorcontrib><creatorcontrib>Kailash, K</creatorcontrib><creatorcontrib>Dickson, D R</creatorcontrib><creatorcontrib>Mahalingam, S</creatorcontrib><creatorcontrib>Raza, A</creatorcontrib><creatorcontrib>Birch, A</creatorcontrib><creatorcontrib>Nuttall, D</creatorcontrib><creatorcontrib>Murali, S R</creatorcontrib><creatorcontrib>Hayton, M J</creatorcontrib><creatorcontrib>Talwalkar, S</creatorcontrib><creatorcontrib>Watts, A C</creatorcontrib><creatorcontrib>Trail, I A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The bone & joint journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Badge, R</au><au>Kailash, K</au><au>Dickson, D R</au><au>Mahalingam, S</au><au>Raza, A</au><au>Birch, A</au><au>Nuttall, D</au><au>Murali, S R</au><au>Hayton, M J</au><au>Talwalkar, S</au><au>Watts, A C</au><au>Trail, I A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medium-term outcomes of the Universal-2 total wrist arthroplasty in patients with rheumatoid arthritis</atitle><jtitle>The bone & joint journal</jtitle><addtitle>Bone Joint J</addtitle><date>2016-12</date><risdate>2016</risdate><volume>98-B</volume><issue>12</issue><spage>1642</spage><epage>1647</epage><pages>1642-1647</pages><artnum>1642</artnum><issn>2049-4394</issn><eissn>2049-4408</eissn><abstract>The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis.
This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures. Accordingly, 75 patients (85 TWAs) were included in the study. There were 59 women and 16 men with a mean age of 59 years (26 to 86). The mean follow-up was 53 months (24 to 120). Clinical assessment involved recording pain on a visual analogue score, range of movement, grip strength, the Quick Disabilities of the Arm, Shoulder and Hand (DASH) and Wrightington wrist scores. Any adverse effects were documented with particular emphasis on residual pain, limitation of movement, infection, dislocation and the need for revision surgery. Radiographic assessment was performed pre-operatively and at three, six and 12 months post-operatively, and annually thereafter. Arthroplasties were assessed for distal row intercarpal fusion and loosening. Radiolucent zones around the components were documented according to a system developed at our institution.
The mean worst pain was 8.1 (3 to 10) pre-operatively and 5.4 (0 to 10) at latest follow-up (p < 0.001). Movements were preserved with mean dorsiflexion of 29
(0
to 70
) and palmar flexion of 21
(0
to 50
). The mean grip strength was 4.8 kg (1.7 to 11.5) pre-operatively and 10 kg (0 to 28) at final follow-up (p < 0.001). The mean QuickDASH and Wrightington wrist scores improved from 61 (16 to 91) to 46 (0 to 89) and 7.9 (1.8 to 10) to 5.7 (0 to 7.8) (p < 0.001). A total of six patients (7%) had major complications; three required revision arthroplasty and three an arthrodesis. The Kaplan-Meier probability of survival using removal of the components as the endpoint was 91% at 7.8 years (95% confidence interval 84 to 91).
The Universal-2 TWA is recommended for use in patients with rheumatoid arthritis. Cite this article: Bone Joint J 2016;98-B:1642-7.</abstract><cop>England</cop><pmid>27909126</pmid><doi>10.1302/0301-620x.98b12.37121</doi><tpages>6</tpages></addata></record> |
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| issn | 2049-4394 2049-4408 |
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| subjects | Adult Aged Aged, 80 and over Arthritis, Rheumatoid - diagnostic imaging Arthritis, Rheumatoid - physiopathology Arthritis, Rheumatoid - surgery Arthroplasty, Replacement - adverse effects Arthroplasty, Replacement - methods Female Follow-Up Studies Hand Strength Humans Joint Prosthesis - adverse effects Male Middle Aged Pain Measurement - methods Pain, Postoperative Prosthesis Design Prosthesis Failure - etiology Prosthesis-Related Infections - etiology Range of Motion, Articular Recovery of Function Retrospective Studies Treatment Outcome Wrist Joint - diagnostic imaging Wrist Joint - physiopathology Wrist Joint - surgery |
| title | Medium-term outcomes of the Universal-2 total wrist arthroplasty in patients with rheumatoid arthritis |
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