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Lee DH, Seo JB, Jung JU, Yoo JS. Proximal row carpectomy with interposition arthroplasty using both capsular flap and acellular human dermal matrix. BMC Musculoskelet Disord 2024; 25:199. [PMID: 38443851 PMCID: PMC10913256 DOI: 10.1186/s12891-024-07305-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND In cases of wrist arthritis, proximal row carpectomy (PRC) has been widely utilized and shown favorable long-term outcomes. However, its applicability is limited in cases where arthritis extends to the lunate fossa or capitate. Recently, surgical approaches combining various methods of interposition arthroplasty have been introduced to overcome these drawbacks. The purpose of this study was to perform PRC and interposition arthroplasty with dorsal capsule and acellular dermal matrix(ADM),and analyze the clinical outcomes of these procedures. METHODS Fourteen cases who underwent PRC and interposition arthroplasty using both dorsal capsular flap and ADM were retrospectively recruited. The researchers assessed the patients' Visual Analog Scale (VAS) pain score, Disabilities of the Arm, Shoulder and Hand (DASH) scores, range of motion (ROM), retear, and radiocarpal distance (RCD). RESULTS One year post-surgery, both the VAS pain scores, DASH scores, and ROM showed statistically significant improvement compared to before the surgery. Upon reviewing the radiological results, the postoperative mean RCD was 4.8 ± 0.8 mm and one year follow up mean RCD was 3.6 ± 0.5 mm at one year post-surgery. Moreover, in the one year follow-up, there was no observed failure of the allodermis graft in any of the cases. CONCLUSION The PRC and interposition arthroplasty with ADM demonstrated significantly improved clinical outcomes after surgery, showing a maintain of RCD without graft failure effectively.
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Affiliation(s)
- Dae-Hee Lee
- Department of Orthopaedic Surgery, Dankook University College of Medicine, Manghyangro 201, Dongnam-gu, Cheonan, 330-715, Chungnam, Korea
| | - Joong-Bae Seo
- Department of Orthopaedic Surgery, Dankook University College of Medicine, Manghyangro 201, Dongnam-gu, Cheonan, 330-715, Chungnam, Korea
| | - Jae-Uk Jung
- Department of Orthopaedic Surgery, Dankook University College of Medicine, Manghyangro 201, Dongnam-gu, Cheonan, 330-715, Chungnam, Korea
| | - Jae-Sung Yoo
- Department of Orthopaedic Surgery, Dankook University College of Medicine, Manghyangro 201, Dongnam-gu, Cheonan, 330-715, Chungnam, Korea.
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Dahmen J, Stufkens SA, Kerkhoffs GM. Prospective Outcomes of a Biological Resurfacing Arthroplasty with Fascia Lata Autograft (BioJoint) for the Treatment of Osteoarthritis of the Midtarsal Joint Complex. Cartilage 2024; 15:37-46. [PMID: 37887431 PMCID: PMC10985392 DOI: 10.1177/19476035231206740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE To determine the clinical, safety, and radiological outcomes after biological resurfacing arthroplasty for the treatment of osteoarthritis (OA) of one or more joints of the midtarsal joint complex. DESIGN All prospectively followed patients with OA to one of or multiple joints of the midtarsal joint complex who were operated with a biological resurfacing arthroplasty with a fascia lata autograft (BioJoint procedure) were included. A total of 7 patients were included (5 males, 2 females), with a median age of 52 (interquartile range [IQR] 44-55) years. The primary outcome was the Numeric Rating Scale (NRS) for pain during walking 2 years postoperatively. Range of motion (ROM), revision rates, and complications were assessed. A postoperative MRI scan was performed to assess progression of OA, graft position and ingrowth, and the degree of bone marrow edema. RESULTS There was a 100% follow-up of the patients (median follow-up: 33 [IQR 26-33] months). The NRS during walking improved from 6 preoperatively to 2 at 2 years postoperatively (P < 0.05). There were no reoperations nor severe complications. The limitations in the ROM remained limited in the majority of the cases. MRI at 2 years of follow-up showed no progression of OA, reduced bone marrow edema, and no loosening of the grafts. CONCLUSION Biological resurfacing arthroplasty with a fascia lata autograft (BioJoint procedure) for OA to one or more joints in the midtarsal joint complex showed clinically relevant pain reduction during walking, improvement in clinical and radiological outcomes, and proved to be safe and durable.
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Affiliation(s)
- Jari Dahmen
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sjoerd A.S. Stufkens
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gino M.M.J. Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands
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Cobb T, Chase C, Cobb J. Arthroscopic Resection Arthroplasty for Scapholunate Advanced Collapse Wrist. J Wrist Surg 2023; 12:528-533. [PMID: 38213559 PMCID: PMC10781571 DOI: 10.1055/s-0043-1768927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 04/03/2023] [Indexed: 01/13/2024]
Abstract
Purpose Scapholunate advanced collapse (SLAC) wrist results from an untreated scapholunate dissociation and is the most common type of degenerative arthritis of the wrist. The most common surgical treatments for SLAC wrist are proximal row carpectomy and four-corner fusion with scaphoid excision. Arthroscopic surgical treatment for SLAC wrist has been reported; however, only limited data on functional outcomes are available. The purpose of this study is to report our 5-year follow-up clinical outcomes for arthroscopic treatment for SLAC wrist. Methods Thirty-one consecutive cases of arthroscopic resection arthroplasty for SLAC wrist were reviewed. Preoperative and postoperative Disabilities of the Arm, Shoulder, and Hand (DASH) scores, range of motion, grip strength, and pain (on 0-10 scale) as well as postoperative satisfaction (0 = not satisfied, 5 = completely satisfied) were recorded. Grip and range of motion were measured by an occupational therapist. Results The preoperative pain score was 7 and 0.18 postoperatively. The mean satisfaction at final follow-up was 4.8. Preoperative and final follow-up scores of the mean DASH was 48 and 3, respectively. The total arc of motion was 114 degrees preoperatively and 126.5 degrees postoperatively. Mean grip strength before surgery was 41 and 49 kg at final follow-up. Conclusion Arthroscopic resection arthroplasty for SLAC wrist results in significant improvement in patient function as measured by DASH and pain scores. Type of Study/Level of Evidence Therapeutic IV.
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Affiliation(s)
- Tyson Cobb
- Shoulder, Elbow, Wrist, and Hand Center of Excellence, Davenport, Iowa
| | - Collin Chase
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Jessica Cobb
- Morsani College of Medicine, University of South Florida, Tampa, Florida
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Proximal row carpectomy of the wrist in the setting of midcarpal arthritis: Survivorship and associated complications in soft tissue interposition versus capitate resurfacing. CURRENT ORTHOPAEDIC PRACTICE 2023. [DOI: 10.1097/bco.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Tendon Transfers, Balloon Spacers, and Bursal Acromial Reconstruction for Massive Rotator Cuff Tears. Clin Sports Med 2023; 42:125-140. [DOI: 10.1016/j.csm.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Petrie K, Cox CT, Becker BC, MacKay BJ. Clinical applications of acellular dermal matrices: A review. Scars Burn Heal 2022; 8:20595131211038313. [PMID: 35083065 PMCID: PMC8785275 DOI: 10.1177/20595131211038313] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The extracellular matrix (ECM) plays an integral role in wound healing. It provides both structure and growth factors that allow for the organised cell proliferation. Large or complex tissue defects may compromise host ECM, creating an environment that is unfavourable for the recovery of anatomical function and appearance. Acellular dermal matrices (ADMs) have been developed from a variety of sources, including human (HADM), porcine (PADM) and bovine (BADM), with multiple different processing protocols. The objective of this report is to provide an overview of current literature assessing the clinical utility of ADMs across a broad spectrum of applications. METHODS PubMed, MEDLINE, EMBASE, Scopus, Cochrane and Web of Science were searched using keywords 'acellular dermal matrix', 'acellular dermal matrices' and brand names for commercially available ADMs. Our search was limited to English language articles published from 1999 to 2020 and focused on clinical data. RESULTS A total of 2443 records underwent screening. After removing non-clinical studies and correspondence, 222 were assessed for eligibility. Of these, 170 were included in our synthesis of the literature. While the earliest ADMs were used in severe burn injuries, usage has expanded to a number of surgical subspecialties and procedures, including orthopaedic surgery (e.g. tendon and ligament reconstructions), otolaryngology, oral surgery (e.g. treating gingival recession), abdominal wall surgery (e.g. hernia repair), plastic surgery (e.g. breast reconstruction and penile augmentation), and chronic wounds (e.g. diabetic ulcers). CONCLUSION Our understanding of ADM's clinical utility continues to evolve. More research is needed to determine which ADM has the best outcomes for each clinical scenario. LAY SUMMARY Large or complex wounds present unique reconstructive and healing challenges. In normal healing, the extracellular matrix (ECM) provides both structural and growth factors that allow tissue to regenerate in an organised fashion to close the wound. In difficult or large soft-tissue defects, however, the ECM is often compromised. Acellular dermal matrix (ADM) products have been developed to mimic the benefits of host ECM, allowing for improved outcomes in a variety of clinical scenarios. This review summarises the current clinical evidence regarding commercially available ADMs in a wide variety of clinical contexts.
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Affiliation(s)
- Kyla Petrie
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Cameron T Cox
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | | | - Brendan J MacKay
- Texas Tech University Health Sciences Center, Lubbock, TX, USA.,University Medical Center, Lubbock, TX, USA
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Mirzayan R, Bouz G. Biologic Tuberoplasty With an Acellular Dermal Allograft for Massive Rotator Cuff Tears. Arthrosc Tech 2021; 10:e1743-e1749. [PMID: 34354916 PMCID: PMC8322474 DOI: 10.1016/j.eats.2021.03.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/16/2021] [Indexed: 02/03/2023] Open
Abstract
We present the technique of biologic tuberoplasty, where an acellular dermal allograft is used to cover the tuberosity in patients with massive irreparable cuff tears to prevent bone-to-bone contact between the tuberosity and acromion when active elevation is attempted. This technique can be performed in patients with massive rotator cuff tears who are low-demand and have significant medical comorbidities, poor bone quality, or who are not candidates for a reverse shoulder arthroplasty or who cannot tolerate a lengthy rehabilitation protocol. It is less time-consuming than a superior capsule reconstruction and more bone-sparing than traditional tuberoplasty. Patients with massive rotator cuff tears involving the supraspinatus and a portion of the infraspinatus lose their force couple, leading to superior humeral head migration with abutment of the tuberosity against the acromion upon deltoid activation. The center of rotation moves superiorly with deltoid contraction, developing an acromiohumeral articulation. This results in bone-to-bone contact between the acromion and humerus, leading to pain and acetabularization of the acromion over time. Coverage of the tuberosity with the acellular dermal allograft acts as an interpositional tissue and prevents bone-to-bone contact between the tuberosity and acromion.
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Affiliation(s)
- Raffy Mirzayan
- Department of Orthopaedics, Kaiser Permanente Southern California, Baldwin Park,Address correspondence to Raffy Mirzayan, M.D., Department of Orthopaedics, 1011 Baldwin Park Blvd., Baldwin Park, CA 91706.
| | - Gabriel Bouz
- Department of Orthopaedics, University of Southern California Keck School of Medicine, Los Angeles, California, U.S.A
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Lee SJ, Rabinovich RV, Kim A. Proximal Row Carpectomy Using Decellularized Dermal Allograft: Preliminary Results. J Wrist Surg 2021; 10:116-122. [PMID: 33815946 PMCID: PMC8012091 DOI: 10.1055/s-0040-1718912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
Objective The purpose of this study was to evaluate the short-term outcomes of patients undergoing proximal row carpectomy (PRC) with interposition arthroplasty using a decellularized dermal allograft. Methods Patients with a minimum of 1-year follow-up after undergoing a PRC using decellularized dermal allograft were contacted for clinical evaluation, radiographs, and postoperative outcome questionnaires, including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire as well as the modified Likert scale for patient satisfaction. Nine of ten (90%) consecutive patients who were treated using this surgical technique were available for follow-up. Results At a mean follow-up of 18 months, a total of nine patients achieved a mean flexion-extension arc of 113 degrees, pronosupination of 170.5 degrees, grip strength of 68 Ibs and pinch strength of 17 Ibs. Relative to the contralateral side, these values were 95, 100, 84 and 82%, respectively. There was significant improvement in the mean DASH score from 63.5 preoperatively to 23.8 postoperatively. Patient satisfaction postoperatively achieved a mean modified Likert score of 1.5. There was no evidence of radiocarpal joint space degeneration or dislocation in any of the patients. No patient suffered wound-related issues, foreign-body reaction to the graft, or other complications. Conclusion PRC with interposition arthroplasty using a decellularized dermal allograft in patients with degenerative changes at the lunate fossa or capitate demonstrates short-term outcomes comparable to what has been reported for routine PRC in patients without degenerative changes affecting the radiocapitate joint. This method of interposition arthroplasty expands the indications for PRC and may help avoid salvage, motion-sacrificing procedures in select patients with late-stage wrist arthritis. Level of Evidence This is a level IV, therapeutic study.
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Affiliation(s)
- Steven J. Lee
- Department of Orthopaedic Surgery, Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT), Lenox Hill Hospital, New York, New York
| | - Remy V. Rabinovich
- Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York
| | - Andrew Kim
- Department of Orthopaedic Surgery, Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT), Lenox Hill Hospital, New York, New York
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