Migration similar between cemented and uncemented cups in trapeziometacarpal arthroplasty .
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(3):33 Acta Orthop. 2013 Feb;84(1):98-105. doi: 10.3109/17453674.2013.765625. Epub 2013 Jan 2328 patients (32 hands) were randomized to evaluate the effectiveness of cemented versus uncemented trapezium cups in total arthroplasty of the trapeziometacarpal joint. Patients were allocated to receive either uncemented Elektra screwed trapezium cups or cemented DLC all-polythelene trapezium cups, and underwent radiostereometric analysis and clinical evaluation for 2 years. Results at 2 years indicated that there were no significant differences between groups for trapezium component migration, and clinical outcomes were similar.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
3/4
Aleatorización
3/4
Medición de resultados
4/4
Inclusión / exclusión
4/4
Descripción de la terapia
4/4
Estadísticas
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
High rates of component loosening - both cemented and uncemented - have been reported in total arthroplasty for trapeziometacarpal joint osteoarthritis, primarily with the trapezium cup. The gold standard implants are considered to be cemented all-polyethylene trapezium cups, yet some studies have found comparable outcomes with the uncemented Elektra hydroxyapatite(HA)-coated trapezium screw cup, with clinical importance of the results undetermined. Therefore, this study was designed to compare the clinical fixation of the two implants.
¿Cuál era la pregunta principal de la investigación?
Did uncemented Elektra screw cups (inserted without threading of the bone) provide similar clinical fixation to cemented DLC trapezium cups when measured after 2 years?
- 2 year migration (total translation) of uncemented Elektra cups was 0.80mm (95%CI -0.56 to 2.2) and 0.36mm (95%CI 0.07-0.64) in DLC all-poly cups, resulting in a statistically insignificant difference of -0.44mm (95%CI -1.7 to 0.86, p=0.3).
- 2 uncemented Elektra cups and 1 cemented DLC cup were classified as loose (total translation > 1.0mm).
- Analysis was also conducted excluding 2 outliers (1 from each group), and found 2-year total translation of 0.19mm (95%CI 0.07-0.31) in uncemented cups and 0.24mm (95%CI 0.16-0.31) in cemented cups.
- No significant differences were observed between groups in grip strength, VAS scores at rest or during activity, or DASH scores at any time throughout the duration of study (P > 0.05).
¿Qué es lo que más debo recordar?
Component migration and clinical outcome were similar between uncemented Elektra HA-coated screwed trapezium cup or cemented DLC all-polyethylene trapezium cup 2 years following total arthroplasty of the trapeziometacarpal joint.
¿Cómo afectará esto al cuidado de mis pacientes?
The results of this study suggest that either cemented or uncemented cups in trapeziometacarpal arthroplasty provide comparably good fixation properties. However, investigation into the long-term survival and outcomes of uncemented cups should be considered, as well as the implications of metal-on-metal articulation in total trapeziometacarpal arthroplasty.
DESCARGO DE RESPONSABILIDAD
El contenido de esta página tiene únicamente fines informativos y no pretende sustituir el consejo, diagnóstico o tratamiento médico profesional. Si necesita tratamiento médico, busque siempre el consejo de su médico o acuda al servicio de urgencias más cercano. Las opiniones, creencias y puntos de vista expresados por las personas sobre el contenido que se encuentra en esta página no reflejan las opiniones, creencias y puntos de vista de OrthoEvidence.
0 de 4 artículos mensuales GRATIS desbloqueados
