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. 2017 Mar 13;1(5):191-196.
doi: 10.1302/2058-5241.1.160008. eCollection 2016 May.

Distal radioulnar joint arthroplasty with implants: a systematic review

Maurizio Calcagni  1 , Thomas Giesen  1
Affiliations

Distal radioulnar joint arthroplasty with implants: a systematic review

Maurizio Calcagni et al. EFORT Open Rev. .

Abstract

A severely painful, dysfunctional, or destroyed distal radio-ulnar joint (DRUJ) can be reconstructed by fusion, interposition of soft tissue, or by arthroplasty using prostheses.The objective of this study was to review the literature on implants and evaluate their effectiveness in terms of pain relief, range of motion and longevity.A search was carried out using protocols and well-defined criteria in PubMed, the Cochrane Library and by screening reference lists. The review was conducted according to PRISMA guidelines.Of the 27 publications reporting on nine different implants, we excluded reports with less than five cases and silastic replacements of the ulna head. Eighteen publications describing a total of five implants were selected for analysis. Nine of the publications were useful for the evaluation of implant longevity. Despite methodological shortcomings in many of the source documents, a summary estimate was possible.It seems that DRUJ implants have good potential to improve function through pain reduction; an improvement was observed in 17 series, although it was significant in only seven series.Instability is not uncommon with ulna head-only implants, but they cause fewer clinical problems and re-interventions than might be expected.The risk of deep infection is small with the available implants.Overall implant survival in papers with at least five years' follow-up is 95%, with a slightly better longevity of 98% for the constrained implants.Periprosthetic osteolysis/radiolucency is frequently reported. Its causes and consequences are not clarified. Cite this article: Calcagni M, Giesen T. Distal radioulnar joint arthroplasty with implants: a systematic review. EFORT Open Rev 2016;1:191-196. DOI: 10.1302/2058-5241.1.160008.

Keywords: arthroplasty; distal radioulnar joint; implants.

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Conflict of interest statement

Conflict of Interest: Dr. Calcagni declares fees outside of the submitted work as a speaker for Swedish Orphan Biovitrum.

Figures

Fig. 1
Fig. 1
The Herbert Ulnar Head Prosthesis implant (KLS Martin Group, Jacksonville, FL) consists of a titanium stem with a ceramic head. A metallic head is optional for revision of failed Sauve-Kapandji.
Fig. 2
Fig. 2
The uHead implant (Small Bone Innovations, Inc, Morrisville, PA) has a similar design to the UHP implant. It is an implant in chromium-cobalt with a metallic head and a slot on the head for the re-fixation of the TFCC.
Fig. 3
Fig. 3
The Aptis DRUJ prostheses. It is formed by an ulnar and radial component. The interface is an ultra-high molecular polyethylene (UHMP) sphere that allows the proximal-distal migration of the radius during prono-supination.
Fig. 4
Fig. 4
The implant introduced by Shuurman. It is a chromium-cobalt implant with a radial and ulnar component. The radial component has a cruciform shape in order to assure stable osseo-integration in the radius. The interface is a polyethylene ring.
See this image and copyright information in PMC

References

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