Re: G.J. Harrison, O.A. Oshin, S.R. Vallabhaneni, J.A. Brennan, R.K. Fisher, R.G. Mcwilliams. Surveillance after evar based on duplex ultrasound and abdominal radiography. Eur J vasc endovasc surg 2011;42:187-92. and response by: S. Dindyal, C. Fardon, C. Kyriakides. Eur J vasc endovasc surg 2011;42:851-852

摘要

Background and purpose: The third generation of total wrist arthroplasty (TWA) was designed to solve the early loosening problem, but there have been few long-term follow-ups. We present the outcome of the biaxial total wrist prosthesis (no longer available) after 58 years of follow-up. Patients and methods: 40 biaxial wrist prostheses were implanted uncemented in 36 patients with rheumatoid arthritis. 32 wrists were followed clinically and radiographically. 7 prostheses had been revised at median 21 (8-71) months; 1 patient died from an unrelated cause. Mean follow-up of the remaining 32 wrists was 6 (5-8) years. Kaplan-Meier survival analysis was performed with revision defined as failure. Results: Survival after 7 years was 81% (95% CI: 64-91). There were 31 complications. 22 wrists showed radiographic loosening. Range of motion improved, except for pronation. The mean DASH score improved and the median postoperative pain score (from 0 to 10) was 0 (0-6) at rest and 0 (0-7) during activity. Interpretation: One quarter of the prostheses had been revised and radiographic loosening had occurred in two thirds of the cases. Radiographic and clinical follow-up is therefore necessary for patients with this implant.