J Wrist Surg 2019; 08(04): 344-350
DOI: 10.1055/s-0039-1681034
Survey or Meta-analysis
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adaptive Proximal Scaphoid Implant: Indications and Long-Term Results

Marie-Anne Poumellec
1   Pôle Urgence Main Nice, Polyclinique Saint François, Nice, France
2   Centre Hospitalo-Universitaire de Nice, Service de Chirurgie Plastique et Réparatrice, Nice, France
,
Olivier Camuzard
2   Centre Hospitalo-Universitaire de Nice, Service de Chirurgie Plastique et Réparatrice, Nice, France
,
Jean-Pierre Pequignot
1   Pôle Urgence Main Nice, Polyclinique Saint François, Nice, France
,
Nicolas Dreant
1   Pôle Urgence Main Nice, Polyclinique Saint François, Nice, France
› Institutsangaben
Funding None.
Weitere Informationen

Publikationsverlauf

02. April 2018

10. Januar 2019

Publikationsdatum:
16. April 2019 (online)

Abstract

Objective This study aims to define the indications of APSI and to evaluate the long-term results.

Patients and Methods This is a monocentric study including patients that underwent an arthroplasty of the scaphoid proximal pole using an APSI between 1994 and 2010. Patients were assessed using autoquestionnaires and measuring ranges of motion, key pinch, and grip strength. X-ray views of the wrist were done to control the mobility of the implant and the evolution of the carpal collapse, if present.

Results There were 19 patients included with a mean follow-up of 11 years. The mean range of motion was 106 degrees (65% of contralateral side) in flexion-extension and 33 degrees (78% of contralateral side) in radialulnar deviation. The mean grip strength was 72% of the contralateral side. The mean Mayo wrist score was 69/100, the mean QuickDASH 26/100, and the mean patient-rated wrist evaluation (PRWE) 25/100. After 10 years, evolution to osteoarthritis was noted in 32% of the patients. This was associated with a decrease of the carpal height. More specifically, capito-lunate osteoarthritis was noted after 10 years and two out of three patients were concerned after 20 years of follow-up. No osteoarthritis was diagnosed at the radiolunate articulation.

Conclusion APSI is a treatment option that enables patients with scaphoid nonunion advanced collapse (SNAC), scapholunate advanced collapse (SLAC) I or II to preserve the strength and mobility with good functional results. But this arthroplasty does not prevent natural evolution to a carpal collapse after a follow-up of 20 years which is clinically well tolerated.

 
  • References

  • 1 Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg Am 1984; 9 (03) 358-365
  • 2 Pequignot JP, Lussiez B, Allieu Y. [A adaptive proximal scaphoid implant]. Chir Main 2000; 19 (05) 276-285
  • 3 Vender MI, Watson HK, Wiener BD, Black DM. Degenerative change in symptomatic scaphoid nonunion. J Hand Surg Am 1987; 12 (04) 514-519
  • 4 Szabo RM, Slater Jr. RR, Palumbo CF, Gerlach T. Dorsal intercarpal ligament capsulodesis for chronic, static scapholunate dissociation: clinical results. J Hand Surg Am 2002; 27 (06) 978-984
  • 5 MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma 1998; 12 (08) 577-586
  • 6 Gummesson C, Ward MM, Atroshi I. The shortened disabilities of the arm, shoulder and hand questionnaire (Quick DASH): validity and reliability based on responses within the full-length DASH. BMC Musculoskelet Disord 2006; 7: 44
  • 7 Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 1987; (214) 136-147
  • 8 Youm Y, McMurthy RY, Flatt AE, Gillespie TE. Kinematics of the wrist. I. An experimental study of radial-ulnar deviation and flexion-extension. J Bone Joint Surg Am 1978; 60 (04) 423-431
  • 9 Grandis C, Berzero GF. Partial scaphoid pyrocarbon implant: personal series review. J Hand Surg Eur 2007; 32: 95-95
  • 10 Pequignot JPAPSI. Surgical technique and physiotherapy for the adaptive proximal scaphoid implant. 2004. Available from: http://www.orthoaktiv.de/uploads/PDF/APSI%20OP%20Technik.pdf . Accessed, January 28, 2019
  • 11 Bellemère P, Bouju Y, Chaise F. , et al. The baud A. Pseudarthrosis of the scaphoide: proximal resection and interposition of a pyrocarbon implant, about 20 cases. CO 030. Chir Main 2011; 30 (06) 429-430 . doi: 10.1016/j.main.2011.10.031
  • 12 Gras M, Wahegaonkar AL, Mathoulin C. Treatment of avascular necrosis of the proximal pole of the scaphoid by arthroscopic resection and prosthetic semireplacement arthroplasty using the pyrocarbon adaptive proximal scaphoid implant (APSI): long-term functional outcomes. J Wrist Surg 2012; 1 (02) 159-164
  • 13 Daruwalla ZJ, Davies K, Shafighian A, Gillham NR. An alternative treatment option for scaphoid nonunion advanced collapse (SNAC) and radioscaphoid osteoarthritis: early results of a prospective study on the pyrocarbon adaptive proximal scaphoid implant (APSI). Ann Acad Med Singapore 2013; 42 (06) 278-284
  • 14 Santos LF, Oliveira M, Santos Pereira R, Frias M, Ferreira A, Canela P. Proximal scaphoid hemiarthroplasty for the treatment of post fracture avascular necrosis of the proximal pole. CO 59. Chir Main 2015; 34 (06) 332-398
  • 15 Dreant N, Pequignot JP, Fernandez J. APSI implant: indications and results. CO 60. Chir Main 2015; 34 (06) 353 . doi: 10.1016/j.main.2015.10.062
  • 16 Aribert M, Bouju Y, Kerjean Y, Gaisne E, Bellemere P. APSI, résultats à 10 ans de recul. J Hand Surg Rehab 2016; 35 (06) 457-458 . doi: 10.1016/j.hansur.2016.10.103