Objective <p>Restoration of pain-free mobility of the trapeziometacarpal joint (TMJ) after a&#xa0;complicated course following arthoplasty through revision surgery with preservation of the prosthesis.</p> Indications <p>Complications during or after implantation of a&#xa0;thumb carpometacarpal joint endoprosthesis, such as first metacarpal shaft fracture, cup malalignment, cup loosening, trapezium fracture, and impingement.</p> Contraindications <p>Insufficient bone stock and/or the presence of infection may argue against revision surgery with preservation of the prosthesis.</p> Surgical technique <p>Various techniques are employed depending on the indication for revision, as outlined below.</p> Postoperative management <p>As with the primary operation, revision of the neck component usually requires only a&#xa0;short period of immobilization. Revision of the cup or stem may require a&#xa0;longer period of immobilization of up to 6&#xa0;weeks, depending on the extent of the revision.</p> Results <p>In our cohort, the postoperative outcome following the described revision procedures was comparable to that after primary thumb carpometacarpal arthroplasty without subsequent revision, with observed differences largely attributable to prolonged immobilization necessitated by revision of the components implanted in the bone.</p>

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Revisionseingriffe nach Daumensattelgelenkendoprothetik

  • Victoria Franziska Struckmann,
  • Thomas Krohn,
  • Ali Ayache,
  • Benjamin Panzram

摘要

Objective

Restoration of pain-free mobility of the trapeziometacarpal joint (TMJ) after a complicated course following arthoplasty through revision surgery with preservation of the prosthesis.

Indications

Complications during or after implantation of a thumb carpometacarpal joint endoprosthesis, such as first metacarpal shaft fracture, cup malalignment, cup loosening, trapezium fracture, and impingement.

Contraindications

Insufficient bone stock and/or the presence of infection may argue against revision surgery with preservation of the prosthesis.

Surgical technique

Various techniques are employed depending on the indication for revision, as outlined below.

Postoperative management

As with the primary operation, revision of the neck component usually requires only a short period of immobilization. Revision of the cup or stem may require a longer period of immobilization of up to 6 weeks, depending on the extent of the revision.

Results

In our cohort, the postoperative outcome following the described revision procedures was comparable to that after primary thumb carpometacarpal arthroplasty without subsequent revision, with observed differences largely attributable to prolonged immobilization necessitated by revision of the components implanted in the bone.