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Scaphoid Trapezium Pyrocarbon Implant (STPI) in scaphotrapeziotrapezoidal (STT) arthritis
STT arthritis is a well-known problem generated idiopathically or secondary to a greater mobility of the scaphoid, for example after scapho-lunate ligament lesions. In these cases, the pure resection of the STT joint would add more instability to the whole system. Therefore, alternatively to the simple resection arthroplasty, the prosthetic augmentation has been proposed. We report the experience with a pyrocarbone convex-concave-shaped prosthesis, which adapts anatomically in the STT joint. After the arthroscopic resection of the distal scaphoid pole, the pyrocarbone implant can be positioned. Three weeks of immobilization seem convenient. In a series of 15 Prof. Christophe Mathoulin’s patients, very good results were achieved after a 39-month follow-up period. Two cases failed because of incomplete resection, especially at the most medial side towards the capitate, which should be approached in this area with accuracy. Arthroscopic resection and pyrocarbone prosthesis have provided very good results in isolated STT arthritis, but remain a new therapeutic option whose validity will have to be proven over the next years.
M Haerle
Lecture
7 years ago
266 views
4 likes
0 comments
05:07
Scaphoid Trapezium Pyrocarbon Implant (STPI) in scaphotrapeziotrapezoidal (STT) arthritis
STT arthritis is a well-known problem generated idiopathically or secondary to a greater mobility of the scaphoid, for example after scapho-lunate ligament lesions. In these cases, the pure resection of the STT joint would add more instability to the whole system. Therefore, alternatively to the simple resection arthroplasty, the prosthetic augmentation has been proposed. We report the experience with a pyrocarbone convex-concave-shaped prosthesis, which adapts anatomically in the STT joint. After the arthroscopic resection of the distal scaphoid pole, the pyrocarbone implant can be positioned. Three weeks of immobilization seem convenient. In a series of 15 Prof. Christophe Mathoulin’s patients, very good results were achieved after a 39-month follow-up period. Two cases failed because of incomplete resection, especially at the most medial side towards the capitate, which should be approached in this area with accuracy. Arthroscopic resection and pyrocarbone prosthesis have provided very good results in isolated STT arthritis, but remain a new therapeutic option whose validity will have to be proven over the next years.
Arthroscopic scaphotrapeziotrapezoidal (STT) joint arthroplasty
Scaphotrapeziotrapezoid (STT) joint osteoarthritis is less known than other types of wrist arthritis.
This disease accounts for only 13% of all wrist arthritis sites. Isolated lesions of this joint are rare and their therapeutic management is complex.
The only treatment proposed used to be STT arthrodesis, a technically difficult procedure which caused numerous complications.
Pseudoarthrosis is common, and STT arthrodesis has been incriminated in the occurrence of radioscaphoid osteoarthritis. Techniques of distal resection combined with interposition of biological tissues such as tendons (flexor carpi radialis) was described in the 1990s. In this video, we present arthroscopic interposition of pyrocarbon implant, a safe and convenient technique for patients, with long-lasting favorable results.
C Mathoulin
Surgical intervention
1 year ago
146 views
1 like
0 comments
04:24
Arthroscopic scaphotrapeziotrapezoidal (STT) joint arthroplasty
Scaphotrapeziotrapezoid (STT) joint osteoarthritis is less known than other types of wrist arthritis.
This disease accounts for only 13% of all wrist arthritis sites. Isolated lesions of this joint are rare and their therapeutic management is complex.
The only treatment proposed used to be STT arthrodesis, a technically difficult procedure which caused numerous complications.
Pseudoarthrosis is common, and STT arthrodesis has been incriminated in the occurrence of radioscaphoid osteoarthritis. Techniques of distal resection combined with interposition of biological tissues such as tendons (flexor carpi radialis) was described in the 1990s. In this video, we present arthroscopic interposition of pyrocarbon implant, a safe and convenient technique for patients, with long-lasting favorable results.