TY - JOUR
T1 - Salvage of Failed Achilles Tendon Interposition Arthroplasty for DRUJ Instability After Ulnar Head Resection with Aptis Prosthesis
AU - Wimalawansa, Sunishka M
AU - Lopez, Rocio Rodriguez
AU - Lucas, Fernando Garcia de
AU - Smet, Luc De
AU - Boin, Michael A.
AU - Dorweiler, Matthew A.
AU - Degreef, Ilse
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Historically, failed conservative treatment for irreparably damaged distal radioulnar joints (DRUJs) is treated via distal ulnar resection or DRUJ fusion; complications include disabling painful convergence of the radius and ulnar stump during lifting Various treatments for radioulnar impingement include distal radioulnar Achilles tendon allograft interpositional arthroplasty. This technique does not adequately prevent radioulnar impingement and we explore an alternative treatment. Methods: We report 7 adult patients who failed Achilles tendon interposition, subsequently treated with Aptis total DRUJ prostheses (mean follow-up, 26 months; range, 7-40). Results: Revision to Aptis prosthesis produced clinically stable DRUJ, improved grip strength and painless lifting capabilities, high patient satisfaction, and no major complications. All returned to daily activities and even recreational sports. Conclusions: Tendon lacks biomechanical features key to the shock-absorbing function of cartilage—features it cannot deliver when used to prevent radioulnar convergence. We report Aptis DRUJ prosthesis as an alternative to the tendon allograft technique.
AB - Background: Historically, failed conservative treatment for irreparably damaged distal radioulnar joints (DRUJs) is treated via distal ulnar resection or DRUJ fusion; complications include disabling painful convergence of the radius and ulnar stump during lifting Various treatments for radioulnar impingement include distal radioulnar Achilles tendon allograft interpositional arthroplasty. This technique does not adequately prevent radioulnar impingement and we explore an alternative treatment. Methods: We report 7 adult patients who failed Achilles tendon interposition, subsequently treated with Aptis total DRUJ prostheses (mean follow-up, 26 months; range, 7-40). Results: Revision to Aptis prosthesis produced clinically stable DRUJ, improved grip strength and painless lifting capabilities, high patient satisfaction, and no major complications. All returned to daily activities and even recreational sports. Conclusions: Tendon lacks biomechanical features key to the shock-absorbing function of cartilage—features it cannot deliver when used to prevent radioulnar convergence. We report Aptis DRUJ prosthesis as an alternative to the tendon allograft technique.
KW - Radioulnar Impingement
KW - Allograft Interposition Arthroplasty
KW - Aptis Total DRUJ Prosthesis
UR - https://corescholar.libraries.wright.edu/orthopaedics/14
UR - https://pubmed.ncbi.nlm.nih.gov/28832196/
U2 - 10.1177/1558944716676251
DO - 10.1177/1558944716676251
M3 - Article
C2 - 28832196
VL - 12
JO - Hand
JF - Hand
ER -