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Radiographic evaluation of osseointegration and loosening of titanium implants in the MCP and PIP joints

Moller, K; Geijer, M; Sollerman, C and Lundborg, Göran LU (2004) In Journal of Hand Surgery 29A(1). p.32-38
Abstract
Purpose: Good to excellent clinical results have been shown in the initial studies on osseointegrated metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint implants that consist of a flexible silicone spacer connected to osseointegrated titanium fixtures. A high fracture rate of the silicone spacer, however, has been reported, diminishing the value of this implant system. The purpose of this study was to evaluate the osseointegration of the titanium fixture itself in a large study group and compare patients with rheumatoid arthritis with those with osteoarthrosis as a base for further development of the implant concept. Methods: Two hundred thirty-nine implants (27 PIP, 212 MCP) in 86 patients were retrospectively evaluated... (More)
Purpose: Good to excellent clinical results have been shown in the initial studies on osseointegrated metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint implants that consist of a flexible silicone spacer connected to osseointegrated titanium fixtures. A high fracture rate of the silicone spacer, however, has been reported, diminishing the value of this implant system. The purpose of this study was to evaluate the osseointegration of the titanium fixture itself in a large study group and compare patients with rheumatoid arthritis with those with osteoarthrosis as a base for further development of the implant concept. Methods: Two hundred thirty-nine implants (27 PIP, 212 MCP) in 86 patients were retrospectively evaluated radiographically. Two hundred implants were in patients with rheumatoid arthritis. Radiographic evaluation included measuring the length and width of resorption zones around the titanium fixtures. A scoring system was used that grouped observations in 4 groups, from 0 (little or no change) to 3 (loosening). Status of the silicone spacer was also noted. Results: At follow-up evaluation an average of 41 months (range, 12-103 months) after surgery, complete osseointegration was found in 450 of 478 fixtures (94%). Loosening was found in 10 proximal and 18 distal fixtures. The proximal fixtures showed loosening mainly during the first 3 years after surgery and the distal fixtures also had loosening. In the 31 MCP joint implants that were evaluated for more than 5 years, the osseointegration rate was 97%. Conclusions: Implant stem fixation with osseointegrated titanium fixtures is a valuable method that works well in rheumatoid arthritis patients. Further development will focus on a more durable constrained joint mechanism. Copyright (C) 2004 by the American Society for Surgery of the Hand. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
hand surgery, osseointegration, arthroplasty
in
Journal of Hand Surgery
volume
29A
issue
1
pages
32 - 38
publisher
Elsevier
external identifiers
  • wos:000188603700006
  • scopus:0742305399
ISSN
1531-6564
DOI
10.1016/j.jhsa.2003.10.001
language
English
LU publication?
yes
id
3b2f9d5a-ed24-4d5f-9df0-3ed73caf3591 (old id 899410)
date added to LUP
2008-01-15 15:16:47
date last changed
2017-02-05 04:23:49
@article{3b2f9d5a-ed24-4d5f-9df0-3ed73caf3591,
  abstract     = {Purpose: Good to excellent clinical results have been shown in the initial studies on osseointegrated metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint implants that consist of a flexible silicone spacer connected to osseointegrated titanium fixtures. A high fracture rate of the silicone spacer, however, has been reported, diminishing the value of this implant system. The purpose of this study was to evaluate the osseointegration of the titanium fixture itself in a large study group and compare patients with rheumatoid arthritis with those with osteoarthrosis as a base for further development of the implant concept. Methods: Two hundred thirty-nine implants (27 PIP, 212 MCP) in 86 patients were retrospectively evaluated radiographically. Two hundred implants were in patients with rheumatoid arthritis. Radiographic evaluation included measuring the length and width of resorption zones around the titanium fixtures. A scoring system was used that grouped observations in 4 groups, from 0 (little or no change) to 3 (loosening). Status of the silicone spacer was also noted. Results: At follow-up evaluation an average of 41 months (range, 12-103 months) after surgery, complete osseointegration was found in 450 of 478 fixtures (94%). Loosening was found in 10 proximal and 18 distal fixtures. The proximal fixtures showed loosening mainly during the first 3 years after surgery and the distal fixtures also had loosening. In the 31 MCP joint implants that were evaluated for more than 5 years, the osseointegration rate was 97%. Conclusions: Implant stem fixation with osseointegrated titanium fixtures is a valuable method that works well in rheumatoid arthritis patients. Further development will focus on a more durable constrained joint mechanism. Copyright (C) 2004 by the American Society for Surgery of the Hand.},
  author       = {Moller, K and Geijer, M and Sollerman, C and Lundborg, Göran},
  issn         = {1531-6564},
  keyword      = {hand surgery,osseointegration,arthroplasty},
  language     = {eng},
  number       = {1},
  pages        = {32--38},
  publisher    = {Elsevier},
  series       = {Journal of Hand Surgery},
  title        = {Radiographic evaluation of osseointegration and loosening of titanium implants in the MCP and PIP joints},
  url          = {http://dx.doi.org/10.1016/j.jhsa.2003.10.001},
  volume       = {29A},
  year         = {2004},
}