scholarly journals Kinematic Accuracy in Tracking Total Wrist Arthroplasty With Biplane Videoradiography Using a Computed Tomography-Generated Model

2019 ◽  
Vol 141 (4) ◽  
Author(s):  
Bardiya Akhbari ◽  
Amy M. Morton ◽  
Douglas C. Moore ◽  
Arnold-Peter C. Weiss ◽  
Scott W. Wolfe ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Joint Replacement ◽  
Wrist Joint ◽  
Radial Component ◽  
Kinematic Accuracy ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Optical Motion ◽  
Wrist Arthroplasty

Total wrist arthroplasty (TWA) for improving the functionality of severe wrist joint pathology has not had the same success, in parameters such as motion restoration and implant survival, as hip, knee, and shoulder arthroplasty. These other arthroplasties have been studied extensively, including the use of biplane videoradiography (BVR) that has allowed investigators to study the in vivo motion of the total joint replacement during dynamic activities. The wrist has not been a previous focus, and utilization of BVR for wrist arthroplasty presents unique challenges due to the design characteristics of TWAs. Accordingly, the aims of this study were (1) to develop a methodology for generating TWA component models for use in BVR and (2) to evaluate the accuracy of model-image registration in a single cadaveric model. A model of the carpal component was constructed from a computed tomography (CT) scan, and a model of the radial component was generated from a surface scanner. BVR was acquired for three anatomical tasks from a cadaver specimen. Optical motion capture (OMC) was used as the gold standard. BVR's bias in flexion/extension, radial/ulnar deviation, and pronosupination was less than 0.3 deg, 0.5 deg, and 0.6 deg. Translation bias was less than 0.2 mm with a standard deviation of less than 0.4 mm. This BVR technique achieved a kinematic accuracy comparable to the previous studies on other total joint replacements. BVR's application to the study of TWA function in patients could advance the understanding of TWA, and thus, the implant's success.

Total Wrist Arthroplasty Alignment and Its Potential Association with Clinical Outcomes

2021 ◽  
Author(s):  
Bardiya Akhbari ◽  
Kalpit N. Shah ◽  
Amy M. Morton ◽  
Janine Molino ◽  
Douglas C. Moore ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Outcomes ◽  
Three Dimensional ◽  
Radial Component ◽  
Single Type ◽  
Radiographic Images ◽  
Computed Tomography Images ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Wrist Arthroplasty

Abstract Purpose There is a lack of quantitative research that describes the alignment and, more importantly, the effects of malalignment on total wrist arthroplasty (TWA). The main goal of this pilot study was to assess the alignment of TWA components in radiographic images and compare them with measures computed by three-dimensional analysis. Using these measures, we then determined if malalignment is associated with range of motion (ROM) or clinical outcomes (PRWHE, PROMIS, QuickDash, and grip strength). Methods Six osteoarthritic patients with a single type of TWA were recruited. Radiographic images, computed tomography images, and clinical outcomes of the wrists were recorded. Using posteroanterior and lateral radiographs, alignment measurements were defined for the radial and carpal components. Radiographic measurements were validated with models reconstructed from computed tomography images using Bland–Altman analysis. Biplanar videoradiography (<1mm and <1 degree accuracy) was used to capture and compute ROM of the TWA components. Linear regression assessed the associations between alignment and outcomes. Results Radiographic measures had a 95% limit-of-agreement (mean difference ±  1.96 × SD) of 3 degrees and 3mm with three-dimensional values, except for the measures of the carpal component in the lateral view. In our small cohort, wrist flexion–extension and radial–ulnar deviation were correlated with volar–dorsal tilt and volar–dorsal offset of the radial component and demonstrated a ROM increase of 3.7 and 1.6 degrees per degree increase in volar tilt, and 10.8 and 4.2 degrees per every millimeter increase in volar offset. The carpal component's higher volar tilt was also associated with improvements in patient-reported pain. Conclusions We determined metrics describing the alignment of TWA, and found the volar tilt and volar offset of the radial component could potentially influence the replaced wrist's ROM. Clinical Relevance TWA component alignment can be measured reliably in radiographs, and may be associated with clinical outcomes. Future studies must evaluate its role in a larger cohort.

Re-motion total wrist arthroplasty: 39 non-rheumatoid cases with a mean follow-up of 7 years

2019 ◽  
Vol 44 (9) ◽  
pp. 946-950 ◽  
Author(s):  
Stefan M. Froschauer ◽  
Maximilian Zaussinger ◽  
Dietmar Hager ◽  
Manfred Behawy ◽  
Oskar Kwasny ◽  
...  
Keyword(s):  
Radial Component ◽  
Visual Analogue Scale Pain ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Analogue Scale Pain ◽  
Wrist Arthroplasty

We evaluated the outcomes of the Re-motion total wrist arthroplasty in 39 non-rheumatoid patients. The mean follow-up was 7 years (range 3–12). Postoperative wrist flexion-extension and radial-ulnar deviation as well as the scores of the Disability of Arm Shoulder and Hand questionnaire and the visual analogue scale pain scores improved significantly. Complications occurred in 13 wrists, five of which required further surgery. The most frequent complication was impingement between the scaphoid and the radial implant (n = 5), which can be avoided by complete or almost complete scaphoid resection. Periprosthetic radiolucency developed around the radial component in three cases and three radial screws loosened. Despite the incidence of high implant survival in 38 of 39 wrists over 7 years (97%), the complication rate is not satisfying. Knowledge of the risk of complications and patient selection are essential when making the decision to choose wrist arthroplasty over arthrodesis. Level of evidence: IV

scholarly journals Gender Differences in Capitate Kinematics are Eliminated After Accounting for Variation in Carpal Size

2008 ◽  
Vol 130 (4) ◽  
Author(s):  
Michael J. Rainbow ◽  
Joseph J. Crisco ◽  
Douglas C. Moore ◽  
Scott W. Wolfe
Keyword(s):  
Gender Differences ◽  
Wrist Joint ◽  
Carpal Bone ◽  
Ulnar Deviation ◽  
Rotation Axes ◽  
Flexion Extension ◽  
Optical Motion ◽  
Joint Center ◽  
Best Fit

Previous studies have found gender differences in carpal kinematics, and there are discrepancies in the literature on the location of the flexion∕extension and radio-ulnar deviation rotation axes of the wrist. It has been postulated that these differences are due to carpal bone size differences rather than gender and that they may be resolved by normalizing the kinematics by carpal size. The purpose of this study was to determine if differences in radio-capitate kinematics are a function of size or gender. We also sought to determine if a best-fit pivot point (PvP) describes the radio-capitate joint as a ball-and-socket articulation. By using an in vivo markerless bone registration technique applied to computed tomography scans of 26 male and 28 female wrists, we applied scaling derived from capitate length to radio-capitate kinematics, characterized by a best-fit PvP. We determined if radio-capitate kinematics behave as a ball-and-socket articulation by examining the error in the best-fit PvP. Scaling PvP location completely removed gender differences (P=0.3). This verifies that differences in radio-capitate kinematics are due to size and not gender. The radio-capitate joint did not behave as a perfect ball and socket because helical axes representing anatomical motions such as flexion-extension, radio-ulnar deviation, dart throwers, and antidart throwers, were located at distances up to 4.5mm from the PvP. Although the best-fit PvP did not yield a single center of rotation, it was still consistently found within the proximal pole of the capitate, and rms errors of the best-fit PvP calculation were on the order of 2mm. Therefore, the ball-and-socket model of the wrist joint center using the best-fit PvP is appropriate when considering gross motion of the hand with respect to the forearm such as in optical motion capture models. However, the ball-and-socket model of the wrist is an insufficient description of the complex motion of the capitate with respect to the radius. These findings may aid in the design of wrist external fixation and orthotics.

In vivo Articular Contact Pattern of a Total Wrist Arthroplasty Design

2021 ◽  
pp. 110420
Author(s):  
Bardiya Akhbari ◽  
Amy M. Morton ◽  
Kalpit N. Shah ◽  
Janine Molino ◽  
Douglas C. Moore ◽  
...  
Keyword(s):  
Contact Pattern ◽  
Total Wrist Arthroplasty ◽  
Wrist Arthroplasty

scholarly journals Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

2021 ◽  
Vol 10 (9) ◽  
pp. 1865
Author(s):  
Stefan M. Froschauer ◽  
Matthias Holzbauer ◽  
Dietmar Hager ◽  
Oskar Kwasny ◽  
Dominik Duscher
Keyword(s):  
Grip Strength ◽  
Clinical Assessment ◽  
Complication Rates ◽  
Proximal Row Carpectomy ◽  
Prosthesis Implantation ◽  
Total Wrist Arthroplasty ◽  
Significant Difference ◽  
Flexion Extension ◽  
Wrist Arthroplasty

High complication rates in total wrist arthroplasty (TWA) still lead to controversy in the medical literature, and novel methods for complication reduction are warranted. In the present retrospective cohort study, we compare the outcomes of the proximal row carpectomy (PRC) method including total scaphoidectomy (n = 22) to the manufacturer’s conventional carpal resection (CCR) technique, which retains the distal pole of the scaphoid (n = 25), for ReMotion prosthesis implantation in non-rheumatoid patients. Mean follow-up was 65.8 ± 19.8 and 80.0 ± 28.7 months, respectively. Pre- and postoperative clinical assessment included wrist flexion-extension and radial-ulnar deviation; Disability of Arm, Shoulder, and Hand scores; and pain via visual analogue scale. At final follow-up, grip strength and satisfaction were evaluated. All complications, re-operations, and revision surgeries were noted. Clinical complications were significantly lower in the PRC group (p = 0.010). Radial impaction was detected as the most frequent complication in the CCR group (n = 10), while no PRC patients suffered from this complication (p = 0.0008). Clinical assessment, grip strength measurements, and the log rank test evaluating the re-operation as well as revision function showed no significant difference. All functional parameters significantly improved compared to preoperative values in both cohorts. In conclusion, we strongly recommend PRC for ReMotion prosthesis implantation.

scholarly journals Accuracy and repeatability of wrist joint angles in boxing using an electromagnetic tracking system

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Ian T. Gatt ◽  
Tom Allen ◽  
Jon Wheat
Keyword(s):  
Wrist Joint ◽  
Tracking System ◽  
Testing Procedure ◽  
Electromagnetic Tracking ◽  
Good Reliability ◽  
Flexion Extension ◽  
In Vivo Testing ◽  
Accuracy And Repeatability ◽  
Electromagnetic Tracking System

AbstractThe hand-wrist region is reported as the most common injury site in boxing. Boxers are at risk due to the amount of wrist motions when impacting training equipment or their opponents, yet we know relatively little about these motions. This paper describes a new method for quantifying wrist motion in boxing using an electromagnetic tracking system. Surrogate testing procedure utilising a polyamide hand and forearm shape, and in vivo testing procedure utilising 29 elite boxers, were used to assess the accuracy and repeatability of the system. 2D kinematic analysis was used to calculate wrist angles using photogrammetry, whilst the data from the electromagnetic tracking system was processed with visual 3D software. The electromagnetic tracking system agreed with the video-based system (paired t tests) in both the surrogate (< 0.2°) and quasi-static testing (< 6°). Both systems showed a good intraclass coefficient of reliability (ICCs > 0.9). In the punch testing, for both repeated jab and hook shots, the electromagnetic tracking system showed good reliability (ICCs > 0.8) and substantial reliability (ICCs > 0.6) for flexion–extension and radial-ulnar deviation angles, respectively. The results indicate that wrist kinematics during punching activities can be measured using an electromagnetic tracking system.

THE EFFECT OF ARTICULAR SURFACE SHAPE AND TENDON FORCES OF TOTAL WRIST ARTHROPLASTY SYSTEMS: A FINITE ELEMENT STUDY

2012 ◽  
Vol 15 (04) ◽  
pp. 1250021 ◽  
Author(s):  
Matthew B. A. McCullough ◽  
Brian D. Adams ◽  
Nicole M. Grosland
Keyword(s):  
Finite Element ◽  
Articular Surface ◽  
Surface Shape ◽  
Element Analysis ◽  
Future Directions ◽  
Ulnar Deviation ◽  
Articular Surfaces ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Wrist Arthroplasty

In order to better understand the behavior of the total wrist implant systems, finite element analysis (FEA) was used to model the articular surfaces of two unconstrained total wrist arthroplasty (TWA) devices. After creating models based on manufacturer specifications, simulations of flexion, extension, radial deviation, ulnar deviation and circumduction were run with simulated moments from surrounding tendons under displacement control. In addition, simulations were run under positioning that represented a pronated and supinated forearm as well as unstable conditions. Understanding implant behavior and capabilities as related to the shape of the articular surfaces is important for proper prescription of implants as well as determining future directions for the design of arthroplasty devices.

scholarly journals Does Total Wrist Arthroplasty for Treatment of Posttraumatic Wrist Joint Osteoarthritis in Young Patients Always Lead to Restriction of High-demand Activities of Daily Living? Case Report and Brief Review of Recent Literature

2017 ◽  
Vol 11 (1) ◽  
pp. 439-446 ◽  
Author(s):  
Ingo Schmidt
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Wrist Joint ◽  
Young Patients ◽  
Fracture Dislocation ◽  
High Demand ◽  
Total Wrist Arthroplasty ◽  
Patient Reported ◽  
Wrist Fusion ◽  
Wrist Arthroplasty

Background: Posttraumatic ulnar carpal translocation is a very rare condition that is caused either by fracture-dislocation injury or by purely ligamentous injury of the wrist. Its prognosis is poor and development of posttraumatic pancarpal wrist joint osteoarthritis is inevitable, and options for treatment are total wrist fusion or total wrist arthroplasty. Methods: A 24-year-old male sustained a fracture-related injury in his left wrist that was accompanied with a second ligamentous distorsion-related injury 1 year later in the same wrist. Seven years after first injury, a posttraumatic pancarpal wrist joint osteoarthritis has developed that was caused by posttraumatic ulnar carpal translocation. The patient was treated by total wrist arthroplasty with use of the MaestroTM Wrist Reconstructive System. Results: With our patient, it is unclear whether posttraumatic ulnar carpal translocation occurred either as result of the first fracture-related injury or as result of the second ligamentous distorsion-related injury or as result of both injuries. The 31-year-old patient could be reemployed completely in his original occupation as a mechanic for big agriculture machines and load his wrist with more than 10 pounds. In order to preserve motion, the patient reported that he would undergo the same total wrist arthroplasty a second time were it necessary. Conclusion: We report on a young male receiving total wrist arthroplasty and resulting in good restoration of his high-demand claims in activities of daily living, respectively. However, it cannot be concluded that total wrist arthroplasty is to be preferred generally over total wrist fusion in young patients. Essential prerequisite for this motion-preserving procedure is the compliance of patients.

Computed tomography-based three-dimensional preoperative planning for total wrist arthroplasty

2020 ◽  
Vol 4 (2) ◽  
pp. 208-211 ◽  
Author(s):  
Yutaro Sugiura ◽  
Takuji Iwamoto ◽  
Taku Suzuki ◽  
Hiroo Kimura ◽  
Noboru Matsumura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Total Wrist Arthroplasty ◽  
Wrist Arthroplasty

scholarly journals Effects of axial load on in vivo scaphoid and lunate kinematics using four-dimensional computed tomography

2020 ◽  
Vol 45 (9) ◽  
pp. 974-980
Author(s):  
Michelle Brinkhorst ◽  
Geert Streekstra ◽  
Joost van Rosmalen ◽  
Simon Strackee ◽  
Steven Hovius
Keyword(s):  
Computed Tomography ◽  
Axial Load ◽  
In Vivo Study ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
Flexion And Extension

This in vivo study investigated the effect of axial load on lunate and scaphoid kinematics during flexion–extension and radial–ulnar deviation of the uninjured wrist using four-dimensional computed tomography. We found that applying axial load to the wrist results in a more flexed, radially deviated and pronated position of the lunate and scaphoid during flexion–extension of the wrist compared with when no load is applied. A larger pronation and supination range of the lunate and scaphoid was seen when the wrist was flexed and extended under axial load, whereas a larger flexion and extension range of the lunate and scaphoid occurred during radial–ulnar deviation of the wrist when axial load was applied.

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