Long-term results of the modular physiological wrist prosthesis (MPW®) in patients with inflammatory diseases

• Verfasst von: Biehl, Christoph [VerfasserIn]
• Verfasst von: Stoll, Martin [VerfasserIn]
• Verfasst von: Heinrich, Martin [VerfasserIn]
• Verfasst von: Biehl, Lotta [VerfasserIn]
• Verfasst von: Jung, Jochen [VerfasserIn]
• Verfasst von: Heiß, Christian [VerfasserIn]
• Verfasst von: Szalay, Gabor [VerfasserIn]
• Titel: Long-term results of the modular physiological wrist prosthesis (MPW®) in patients with inflammatory diseases
• Verf.angabe: Christoph Biehl, Martin Stoll, Martin Heinrich, Lotta Biehl, Jochen Jung, Christian Heiss and Gabor Szalay
• E-Jahr: 2021
• Jahr: 18 April 2021
• Umfang: 12 S.
• Fussnoten: Gesehen am 07.06.2021
• Titel Quelle: Enthalten in: Life
• Ort Quelle: Basel : MDPI, 2011
• Jahr Quelle: 2021
• Band/Heft Quelle: 11(2021), 4, Artikel-ID 355, Seite 1-12
• ISSN Quelle: 2075-1729
• DOI: doi:10.3390/life11040355
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: DASH
• Sach-SW: MPW^®-prosthesis
• Sach-SW: national public health survey
• Sach-SW: rheumatoid arthritis
• Sach-SW: SF-36
• Sach-SW: wrist function
• Sach-SW: wrist prosthesis
• K10plus-PPN: 1759894745

Abstract

The wrist is among the predilection sites of over 90% of cases of rheumatoid arthritis (RA). In advanced cases, total wrist arthroplasty (TWA) is an alternative to arthrodesis. The aim of this study is to present the long-term results of the modular physiological wrist prosthesis (MPW®) and to match them in context with the results of a standard population survey. In a retrospective study with follow-up, patients with an MPW® endoprosthesis were evaluated concerning the clinical and radiological outcome, complications were reviewed (incidence and type), and conversion to wrist fusion was assessed. Patient function measurements included the Mayo wrist score, the patient-specific wrist test, and therefore the DASH score (arm, shoulder, and hand). Thirty-four MPW® wrist prostheses were implanted in 32 patients, including thirty primary implantations and four changes of the type of the endoprosthesis. Sixteen patients (18 prostheses) underwent clinical and radiological follow-up. The average follow-up time was 8.5 years (1 to 16). Poor results of the MPW prosthesis are caused by the issues of balancing with luxation and increased PE wear. Salvage procedures included revision of the TWA or fusion. In successful cases, the flexion and extension movement averaged 40 degrees. The grip force was around 2.5 kg. The common DASH score was 79 points, with limited and problematic joints of the upper extremity. The MPW wrist prosthesis offered good pain relief and functional movement in over 80% of cases. The issues of dislocation and increased PE wear prevent better long-term results, as do the joints affected. A follow-up study with fittings under a contemporary anti-rheumatic therapy with biologicals suggests increasing score results. Type of study/level of evidence: Case series, IV.