Publications by authors named "Stephan Schindele"

We compared the 2 year outcomes after proximal interphalangeal joint surface replacement in 68 joints with severe (>15°) preoperative longitudinal axis deviation and 50 joints without (<5°) preoperative deviation. Patients in both groups had a mean preoperative brief Michigan Hand Outcomes Questionnaire score of 47 and had similar 2 year scores of 72 (95% CI 68-77) (severe deviation) and 70 (95% CI 65-76) (no deviation). Pain, proximal interphalangeal joint range of motion, grip strength and complications did not differ between the groups at 2 years.

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Deformities of the thumb in the context of rheumatoid arthritis are not uncommon and lead to early functional limitations due to the great importance of the first ray in almost all gripping functions. The various deformities of the thumb were already classified by Nalebuff in 1968, and this classification is still valid today. The treatment of a thumb deformity depends on the functional limitations, the number of affected joints, and the patient's requirements.

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This case report describes the 4-year outcomes of proximal interphalangeal joint arthroplasty in a 14-year-old girl with a stiff joint after trauma. At follow-up, active range of motion was 35°, she was pain-free and satisfied with the outcome. Implant arthroplasty seems to be a valuable option for young patients with persistent post-traumatic stiff and deviated PIP joints to-at least temporarily-increase quality of life.

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We compared the effects of capsule resection versus capsule suturing in patients treated with a dual-mobility trapeziometacarpal joint prosthesis. We included 131 patients with capsular resection and 57 patients with repair. The mean scores for pain and the brief Michigan Hand Outcomes Questionnaire were similar between the groups preoperatively and at 6 weeks and 1 year postoperatively.

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Objectives: The aim was to evaluate patient satisfaction with online video consultations in assessing hand disorder.

Material And Methods: This prospective study included patients who attended a video consultation, either as an initial meeting to assess the need for further evaluation or treatment or as an early postoperative follow-up consultation. After the consultation, they completed a satisfaction questionnaire.

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The purpose of this study was to analyse the 1-year outcomes after combining a surface replacing proximal interphalangeal joint arthroplasty and a distal interphalangeal screw arthrodesis and to compare the combined surgery with proximal interphalangeal joint arthroplasty alone. To obtain two groups with similar baseline data from our prospective registry, propensity score matching was used to match 23 fingers with the combined operations with 115 fingers with proximal interphalangeal joint arthroplasty alone. One year after surgery, the mean ranges of motion were 60° (95% CI: 53° to 67°) in the combined group and 63° (95% CI: 60° to 66°) in the control group and did not differ significantly.

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We compared the short-term recovery of patients treated with trapeziometacarpal joint (TMJ) implant arthroplasty versus resection-suspension-interposition (RSI) arthroplasty. Implant patients ( = 147) had a better 3-month postoperative brief Michigan Hand Outcomes Questionnaire (MHQ) score (mean 82) compared to RSI patients ( = 127), who had a mean score of 69. Key pinch strength at 3 months was also higher in the implant group compared to the RSI group (6.

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Article Synopsis
  • * Out of 130 patients, 4 required revision surgeries leading to a high 2-year survival rate of 96%, but 17 patients experienced complications such as de Quervain stenosing vaginosis and trigger thumb.
  • * Significant improvements were observed in pain levels (decreasing from a median of 5 to 0) and key pinch strength (increasing from 4.5 kg to 7.0 kg), suggesting that the Touch® prosthesis is an effective treatment for trapeziometacarpal
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Purpose: There is ongoing discussion about the level of symptoms patients with proximal interphalangeal (PIP) joint osteoarthritis should have to undergo surgery. The aims of our study were to determine the minimal important change (MIC) and patient acceptable symptom state (PASS) for PIP joint range of motion (ROM), and define clinically relevant thresholds of preoperative pain and function at which patients have the greatest chance to achieve a MIC and PASS in these outcomes 1 year after PIP arthroplasty.

Methods: We analyzed registry data that included patients with PIP joint osteoarthritis who underwent an arthroplasty for this condition and had a 1-year follow-up.

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Purpose: We evaluated the 1-year postoperative clinical and patient-reported outcomes in patients who had a 3-dimensional planned corrective osteotomy of their distal radius, radial shaft, or ulnar shaft using a printed, anatomical, patient-tailored plate to determine the feasibility and effectiveness of this methodology.

Methods: Simulations in computer-assisted preoperative planning of corrective osteotomies resulted in 3-dimensionally printed surgical guides, surgical models, and anatomically customized plates for application at the distal radius and forearm. Patients with malunions of the distal radius or forearm who underwent fixation with the custom-made plates were documented in our registry.

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Degenerative changes of the finger joints often lead to various surgical treatments such as arthrodesis or artificial joint replacement. There are a lot of surgical approaches for surgeons to choose from. The different approaches with their characteristic advantages and disadvantages during surgery and for the postoperative treatment should be selected and applied based on patient-, implant- and aftercare-specific indications.

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This study investigated revision surgery for the thumb after failed trapeziectomy with ligament reconstruction and tendon interposition and defined a revision concept. Twenty-four patients with 25 affected thumbs were examined at a mean of 5.5 years after their last revision operation.

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The purpose of this prospective study was to evaluate the 5-year outcomes in patients after proximal interphalangeal joint arthroplasty using the surface replacing implant, CapFlex-PIP. Ninety-two prosthesis were implanted and 65 patients with 68 implants were available for follow-up. The brief Michigan Hand Outcomes Questionnaire score improved significantly from 45 (SD 15) before surgery to 71 (SD 17) at 5 years.

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Introduction: The aim was to analyse complications after surface replacing and silicone proximal interphalangeal (PIP) joint arthroplasty.

Materials And Methods: All complications, reoperations (subsequent intervention without implant modification) and revisions (subsequent surgery with implant modification or removal) were extracted out of our registry for two cohorts: (1) Patients who received a surface replacing arthroplasty at the PIP joint using the CapFlex-PIP prosthesis and (2) patients who received a PIP silicone implant. Furthermore, radiographs were evaluated for deviations from the longitudinal finger axis.

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The aim of this study was to evaluate patient satisfaction after distal interphalangeal joint silicone arthroplasty and compare this outcome to that achieved with screw arthrodesis. On average 4.4 years after surgery, range of motion of the distal interphalangeal joint, pain on a numeric rating scale, satisfaction, and hand appearance of 48 patients (78 treated fingers) were assessed.

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The objective was to compare outcomes of the volar, Chamay and tendon splitting approaches for proximal interphalangeal joint arthroplasty using a surface-replacing implant (CapFlex-PIP). One-hundred prospectively documented patients with a 2-year follow-up were included. Range of proximal interphalangeal joint motion, the brief Michigan Hand Outcomes Questionnaire and complications were analysed.

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Background: For the treatment of deformed finger middle joints that occur as a result of osteoarthritis or inflammatory and post-traumatic destruction, artificial joint replacement is an option to arthrodesis. Hereby mobility can be obtained, which is why this method generally has a higher acceptance.

Discussion: What clinical and subjective results can be expected after artificial finger middle joint replacement and what is the expected complication rate for the different types of joints?

Material And Methods: We present our experiences with artificial joint replacement with various implants over the past decades as well as promising new developments of the last 10 years.

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Our aim was to determine the minimal important change and patient acceptable symptom state for pain and the brief Michigan Hand Outcomes Questionnaire in patients 1 year after proximal interphalangeaI joint arthroplasty. We analysed data of 100 patients from our prospective registry. The minimal important change and patient acceptable symptom state were determined with anchor-based methods, and patients with better or worse baseline status were examined.

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This systematic review and meta-analysis investigates the prevalence of complications, reoperations (surgeries without implant modifications) and revisions (surgeries with implant modifications) after proximal interphalangeal joint arthroplasty with pyrocarbon, metal-polyethylene and silicone implants. Thirty-four articles investigating 1868 proximal interphalangeal joints were included. Implant-related complications were associated with 14%, 10% and 11% of the pyrocarbon, metal-polyethylene and silicone implants, respectively, yet these rates were not significantly different from one another.

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Purpose: The objective of this randomized controlled trial was to compare the 12-month postoperative Michigan Hand Outcomes Questionnaire (MHQ) total score between patients with osteoarthritis (OA) at the first carpometacarpal (CMC I) joint who underwent trapeziectomy with suspension-interposition arthroplasty using the flexor carpi radialis (FCR) tendon and those receiving a human dermal collagen template (allograft).

Methods: We included 60 patients with CMC I OA who met the indications for surgery. They were randomized into 1 of 2 groups: trapeziectomy using the FCR tendon or trapeziectomy with the allograft for suspension-interposition.

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Purpose: The brief Michigan Hand Outcomes Questionnaire (briefMHQ) was developed as a shorter version of the Michigan Hand Outcomes Questionnaire (MHQ), but its measurement properties have not been investigated in patients with Dupuytren contracture. The objective of the study was to investigate the reliability, validity, responsiveness, and interpretability of the briefMHQ.

Methods: Fifty-seven patients diagnosed with Dupuytren contracture completed the briefMHQ as well as the full-length MHQ and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at baseline.

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Introduction: Primary press fit and secondary osteointegration is a precondition for component anchoring in articular surface replacements, also in the case of proximal interphalangeal (PIP) joint. Nevertheless, many existing prostheses for the PIP joint have failed to show sufficient osteointegration. CapFlex-PIP(©) implant is a modular metal-polyethylene surface replacement for the PIP joint consisting of a proximal and distal component each having a titanium pore backside, which allows secondary osteointegration at the bone-implant interface.

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Purpose: To evaluate the one-year postoperative clinical and patient-rated outcomes in patients receiving proximal interphalangeal (PIP) joint arthroplasty with a modular surface gliding implant, CapFlex-PIP.

Methods: 10 patients each with primary osteoarthritis of a single PIP joint were assessed preoperatively (baseline), at 6 weeks, and 3, 6, and 12 months after CapFlex-PIP arthroplasty for lateral stability and range of motion of the affected digit. In addition, patients rated their pain using a numeric rating scale and function and overall assessment of their treatment and condition using the quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient Evaluation Measure (PEM) questionnaires, respectively.

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