Article

The goal of our work was to evaluate the results of the Isis((R))
trapeziometacarpal prosthesis. METHODS: Our retrospective study included 26
patients, 30 prosthesis. The mean follow-up was 30 months. Preoperatively, the
pain was 8.1 out of 10, the QuickDASH was 68.5 and the average Kapandji score was
7.8. The Dell's stage was 2.3. The prosthesis used was hybrid: the trapezial cup
was cemented in 90% of cases, and the metacarpal stem was cementless. RESULTS:
Eighty-seven percent of patients were satisfied or very satisfied. At last
follow-up, the pain was 3.4 out of 10, the QuickDASH was 37.8, and the average
Kapandji score 9.1. The range of motion in flexion-extension and
abduction-adduction were respectively 30.5 degrees and 31.7+/-11 degrees . The
strength of the key-pinch, pulp-pinch and grasp averaged 75% of the contralateral
side. On radiologic review, the rate of radiolucent lines was 20%, and the
loosening or non-osteointegration rate 10%. No dislocation was noted. One
surgical revision was necessary for symptomatic metacarpal non-osteointegration.
The survival rate of the prosthesis was 93% at 42 months. DISCUSSION: Clinical
results are good. However, the rate of abnormal radiographic images (30%) at 30
months follow-up must incite caution. Although these prosthetic loosenings seem
to be less symptomatic, a longer follow-up is necessary to assess the
sustainability of clinical results and the future of these periprosthetic
radiolucent lines. This led us to change our practice to using noncemented
prostheses from now on.
CI - Copyright (c) 2013. Published by Elsevier SAS.

Langue : FRANCAIS