Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory Diseases

The wrist is among the predilection sites of over 90% of cases of rheumatoid arthritis (RA). In advanced cases, total wrist arthroplasty (TWA) is an alternative to arthrodesis. The aim of this study is to present the long-term results of the modular physiological wrist prosthesis (MPW<sup>®<...

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Main Authors: Christoph Biehl, Martin Stoll, Martin Heinrich, Lotta Biehl, Jochen Jung, Christian Heiss, Gabor Szalay
Format: Article
Language:English
Published: MDPI AG 2021-04-01
Series:Life
Subjects:
Online Access:https://www.mdpi.com/2075-1729/11/4/355
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author Christoph Biehl
Martin Stoll
Martin Heinrich
Lotta Biehl
Jochen Jung
Christian Heiss
Gabor Szalay
author_facet Christoph Biehl
Martin Stoll
Martin Heinrich
Lotta Biehl
Jochen Jung
Christian Heiss
Gabor Szalay
author_sort Christoph Biehl
collection DOAJ
description The wrist is among the predilection sites of over 90% of cases of rheumatoid arthritis (RA). In advanced cases, total wrist arthroplasty (TWA) is an alternative to arthrodesis. The aim of this study is to present the long-term results of the modular physiological wrist prosthesis (MPW<sup>®</sup>) and to match them in context with the results of a standard population survey. In a retrospective study with follow-up, patients with an MPW<sup>®</sup> endoprosthesis were evaluated concerning the clinical and radiological outcome, complications were reviewed (incidence and type), and conversion to wrist fusion was assessed. Patient function measurements included the Mayo wrist score, the patient-specific wrist test, and therefore the DASH score (arm, shoulder, and hand). Thirty-four MPW<sup>®</sup> wrist prostheses were implanted in 32 patients, including thirty primary implantations and four changes of the type of the endoprosthesis. Sixteen patients (18 prostheses) underwent clinical and radiological follow-up. The average follow-up time was 8.5 years (1 to 16). Poor results of the MPW prosthesis are caused by the issues of balancing with luxation and increased PE wear. Salvage procedures included revision of the TWA or fusion. In successful cases, the flexion and extension movement averaged 40 degrees. The grip force was around 2.5 kg. The common DASH score was 79 points, with limited and problematic joints of the upper extremity. The MPW wrist prosthesis offered good pain relief and functional movement in over 80% of cases. The issues of dislocation and increased PE wear prevent better long-term results, as do the joints affected. A follow-up study with fittings under a contemporary anti-rheumatic therapy with biologicals suggests increasing score results. Type of study/level of evidence: Case series, IV.
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spelling doaj.art-a8d6604160514a528bc3ef25a18ac5882023-11-21T16:05:55ZengMDPI AGLife2075-17292021-04-0111435510.3390/life11040355Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory DiseasesChristoph Biehl0Martin Stoll1Martin Heinrich2Lotta Biehl3Jochen Jung4Christian Heiss5Gabor Szalay6Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, 35392 Giessen, GermanyOrthopedic Department, Diakonie Hospital, 55543 Bad Kreuznach, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, 35392 Giessen, GermanyMedical Faculty Heidelberg, Heidelberg University, 69117 Heidelberg, GermanyOrthopedic Department, Diakonie Hospital, 55543 Bad Kreuznach, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, 35392 Giessen, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, 35392 Giessen, GermanyThe wrist is among the predilection sites of over 90% of cases of rheumatoid arthritis (RA). In advanced cases, total wrist arthroplasty (TWA) is an alternative to arthrodesis. The aim of this study is to present the long-term results of the modular physiological wrist prosthesis (MPW<sup>®</sup>) and to match them in context with the results of a standard population survey. In a retrospective study with follow-up, patients with an MPW<sup>®</sup> endoprosthesis were evaluated concerning the clinical and radiological outcome, complications were reviewed (incidence and type), and conversion to wrist fusion was assessed. Patient function measurements included the Mayo wrist score, the patient-specific wrist test, and therefore the DASH score (arm, shoulder, and hand). Thirty-four MPW<sup>®</sup> wrist prostheses were implanted in 32 patients, including thirty primary implantations and four changes of the type of the endoprosthesis. Sixteen patients (18 prostheses) underwent clinical and radiological follow-up. The average follow-up time was 8.5 years (1 to 16). Poor results of the MPW prosthesis are caused by the issues of balancing with luxation and increased PE wear. Salvage procedures included revision of the TWA or fusion. In successful cases, the flexion and extension movement averaged 40 degrees. The grip force was around 2.5 kg. The common DASH score was 79 points, with limited and problematic joints of the upper extremity. The MPW wrist prosthesis offered good pain relief and functional movement in over 80% of cases. The issues of dislocation and increased PE wear prevent better long-term results, as do the joints affected. A follow-up study with fittings under a contemporary anti-rheumatic therapy with biologicals suggests increasing score results. Type of study/level of evidence: Case series, IV.https://www.mdpi.com/2075-1729/11/4/355wrist prosthesisMPW<sup>®</sup>-prosthesisrheumatoid arthritiswrist functionDASHSF-36
spellingShingle Christoph Biehl
Martin Stoll
Martin Heinrich
Lotta Biehl
Jochen Jung
Christian Heiss
Gabor Szalay
Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory Diseases
Life
wrist prosthesis
MPW<sup>®</sup>-prosthesis
rheumatoid arthritis
wrist function
DASH
SF-36
title Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory Diseases
title_full Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory Diseases
title_fullStr Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory Diseases
title_full_unstemmed Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory Diseases
title_short Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW<sup>®</sup>) in Patients with Inflammatory Diseases
title_sort long term results of the modular physiological wrist prosthesis mpw sup r sup in patients with inflammatory diseases
topic wrist prosthesis
MPW<sup>®</sup>-prosthesis
rheumatoid arthritis
wrist function
DASH
SF-36
url https://www.mdpi.com/2075-1729/11/4/355
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