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Evolution Of Thumb CMC Joint Arthroplasty: Early Experience with NuGrip Implant.
Alexey Markelov MD, Garrett Vangelisti MD, Ernest Manders MD
University of Pittsburgh Medical Center
2016-02-04
Presenter: Alexey Markelov
Affidavit:
100% of the work on this project represents the original work of the resident
Director Name: Joseph Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Introduction:
While for most arthritic joints implant arthroplasty has largely replaced resection arthroplasty this hasn't been the case for thumb CMC joint arthritis. Early ball-and-socket prosthetic designs were notorious for persistent problems with trapezial component. Since the concept of hemiarthroplasty was introduced for treatment of thumb CMC arthritis newer implant designs were developed. We report our early experience with NuGrip pyrocarbon implant.
Results:
Twenty-four implants were placed in 22 patients with mean follow up period 10 months. Postoperative measurements showed average radial and palmar abduction of 43° and 61°, respectively, compared with 44° and 60° on the opposite hand. Analysis of patient questionnaires revealed significant subjective improvement in pain, deformity, function, and strength (8.3 to 2.2, p<0.05). Overall satisfaction was high at 78% with 87% of patients stating that they would have the surgery performed again. We found significant reduction in pain scores on a 10-point scale (p
Implant hemiarthroplasty remains an attractive option for the patients with advanced thumb CMC joint arthritis. Our study showed encouraging short-term results with NuGrip implant hemiarthroplasty. Theoretical advantages of implant hemiarthroplasty of achieving a pain-free, stable and flexible joint with preservation of thumb length can be certainly reached with prosthetic implant.
