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Ulnar head arthroplasty leads to improved VAS and modified DASH scores
Investigators noted the procedure helps with pain management for patients with ulnar head osteoarthritis, inflammatory arthritides or DRUJ dysfunction.
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Ulnar head arthroplasty was associated with pain relief and greater function in patients with various pathologies for which the procedure is indicated, including distal radioulnar joint disorders, according to results of a study conducted by investigators in the Department of Trauma & Orthopaedics at Brighton & Sussex University Hospitals in the United Kingdom.
“Ulnar head replacement is a successful procedure in relieving pain in distal radioulnar joint disorders regardless of etiology and successful functional outcomes can be achieved in patients treated with distal radial ulnar joint osteoarthritis and previous traumatic injuries,” Benjamin D. Chatterton, BSc (Hons), BMBS, an undergraduate student, said.
Chatterton and colleagues studied results with the Herbert ulnar head prosthesis (Martin MedizinTechnik; Tuttlingen, Germany).
Image: Chatterton BD
Best indication
Mean scores with a modified version of the DASH score, called the QuickDASH score, were 40.05 ± 18.72 points, the investigators reported. However, the best results were in patients who had osteoarthritis that stemmed from a distal radioulnar joint (DRUJ) disorder, where the mean scores were 29.83 ± 18.77 points, according to the abstract.
There was a significant decrease in pain based on the mean preoperative Visual Analog Scale (VAS) score of 8.29 ± 1.52 points, which changed to a mean VAS postoperative score of 3.19 ± 2.20 points postoperatively.
Of patients who underwent the procedure, 8 patients had osteoarthritis. Six patients were diagnosed with inflammatory arthritides and 3 patients had post-traumatic DRUJ dysfunction, according to the abstract.
Some revisions, residual pain
Three of the procedures were revision surgery, and the original indication for surgery was unknown in one patient.
“Although existing procedures for painful DRUJ disorders exist, ulnar head arthroplasty is something that can be used in a select group of patients,” consultant hand surgeon Christopher Williams, FRCS, senior author of the study, told Orthopaedics Today Europe. “In particular, it can be done in a patient with ulnar head excision,” he said, noting none of the stems have yet been revised for loosening.
Among the postoperative complications was one case where the prosthesis impinged and the patient underwent ulnar shortening to resolve the problem and three patients who experienced residual pain. Another patient ultimately went on to total wrist arthroplasty, according to the study results. – by Jeff Craven
- Reference:
- Chatterton BD. Paper #12-3983. Presented at: EFORT Congress; May 23-25, 2012. Berlin.
- For more information:
- Benjamin D. Chatterton, BSc (Hons), BMBS, can be reached at University Hospital of North Staffordshire NHS Trust, Hartshill Rd., Stoke-on-Trent, ST4 7PX, United Kingdom; email: benjamin.chatterton@uhs.nhs.uk.
- Christopher Williams, FRCS, can be reached at the Department of Trauma & Orthopaedics, Brighton & Sussex University Hospital NHS Trust, Brighton, United Kingdom; email: jointhands@doctors.org.uk.
Disclosures: Chatterton and Williams have no relevant financial disclosures.