American Association for Hand Surgery
Theme: Beyond Innovation

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Income and Gender Data in Orthopaedic Hand Surgery: How do we Stack Up?
Ethan S Krell, MBS1; Nicole Rynecki, BA1; Omkar Baxi, MD2; Kathleen Beebe, MD1; Irfan Ahmed, MD1
1Rutgers New Jersey Medical School, Newark, NJ, 2Rutgers New Jersey Medical School, Westfield, NJ

INTRODUCTION: The new generation of ISIS TMC total joint arthroplasty is a modular, semi retentive, uncemented implant. It was introduced in 2007 for the treatment of symptomatic trapeziometacarpal osteoarthritis. The primary outcome of this retrospective study is to report the medium- to long-term joint survival of this prosthesis. Our secondary outcomes are the clinical and functional results. MATERIALS AND METHODS: This multicenter retrospective study involved 89 patients who underwent 107 Isis prosthesis implantations from november 2006 to september 2009, and who had a minimum of 1 years follow-up. Clinical and radiological assessment was recorded. We compared the means of the Kapandji index, the grip strength, the pinch strength, qdash, before surgery and at the latest follow-up. Clinical and radiological complications were registered. The Kaplan-Meier method was used to estimate implant survival over time. RESULTS: We included 107 prostheses in the survival analysis with a mean follow-up of 45.6 months. No prostheses required revision surgery and no implant failed. No dislocation was pointed. For the survival analysis, we made 2 survival curves; in the first curve, survival means that the prosthesis has not been removed; the survival after a mean of 45.6 years was 100%. In the second curve, indication for revision was the marker of failure; the survival after a mean of 45.6 years was 86.9%. A total of 107 arthroplasties from 89 patients were included in the clinical analysis. The mean age at surgery was 63.1 years and the median follow-up was 76 months. At 5 years' follow-up, the mean Quick Dashimproved from 61.3 17.1 to 17.5 16. The mobility of the thumb was restored to a range of motion comparable with that of the contralateral thumb. Opposition, defined by the kapandji score, was almost normal, as was the final mean key pinch and grip strength, which improved by 26% and 43%, respectively DISCUSSION: The anatomical curves of the modular metacarpal part, which are retently associated with the cup, appear to be able to meet the biomechanical stresses of the Trapezometacarpal region. Although asymptomatic, the radioluminecent light around the prosthetic parts appears to be the main evolution to be monitored.


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