This study reviews the performance of the Aptis distal radioulnar joint arthroplasty by comparing multiple kinematic and geometric measurements in the operated and contralateral healthy forearm to elucidate whether these are altered after arthroplasty. Forearm geometry and motion were captured using 3-D and 4-D computed tomography in 12 patients with unilateral Aptis arthroplasties. After segmentation and registration, the axis of forearm rotation, translation of the radius along the ulna and range of wrist flexion-extension were measured, and the Dice coefficient and Hausdorff distance were calculated. The forearm rotation axis in the corrected arm deviated 2.3° from the healthy contralateral rotation axis, radial translation along the ulna decreased by 45% and wrist flexion-extension also decreased significantly. Multiple intra-individual geometric differences were observed. The Aptis distal radioulnar joint arthroplasty considerably alters forearm kinematics, which can have clinical implications. IV.
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http://dx.doi.org/10.1177/17531934241274142 | DOI Listing |
J Hand Surg Glob Online
November 2024
Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY.
Purpose: This case series presents four cases of periprosthetic ulna fractures following Aptis distal radioulnar joint (DRUJ) arthroplasty to elucidate clinical characteristics, contributing factors, management challenges, and short-term outcomes following this rare complication and to propose prevention and optimal treatment strategies.
Methods: We conducted a retrospective review of 239 Aptis DRUJ prostheses implanted between 2012 and 2022 at a single institution. We identified four cases of periprosthetic ulna fractures and assessed demographics, surgical indications, time to fracture, mechanism of injury, radiographic findings, treatment modalities, associated complications, and outcomes.
J Hand Surg Eur Vol
October 2024
Amsterdam UMC location University of Amsterdam, Biomedical Engineering and Physics, Amsterdam, the Netherlands.
J Wrist Surg
August 2024
Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, The Netherlands.
The Aptis distal radioulnar joint (DRUJ) implant has been commonly used to replace the DRUJ and restore wrist function in patients with a severely destroyed DRUJ. Promising results have been described in the literature. However, the clinical results in a multicenter setting are sparse and variable.
View Article and Find Full Text PDFHand (N Y)
March 2024
Indiana Hand to Shoulder Center, Indianapolis, USA.
Background: Pathology of the distal radioulnar joint (DRUJ) including instability and arthritis presents a challenge for hand and upper extremity surgeons. Surgical options include a Darrach procedure and similar resections, soft tissue interposition arthroplasty, and a one-bone forearm. In 2005, a prosthesis for DRUJ arthroplasty was approved for use in the United States.
View Article and Find Full Text PDFJ Wrist Surg
February 2024
Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Severely destroyed wrists can be managed by combined radiocarpal and distal radioulnar joint (DRUJ) replacement that reduces pain while mobility is ought to be reserved. The combination of these arthroplasties is rarely reported in the literature. This article describes the clinical outcomes of six consecutive patients with both total wrist and Aptis DRUJ arthroplasty with a median follow-up of 50 months (range: 18-108 months).
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