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Distal radioulnar joint stabilization with open foveal reinsertion versus tendon graft reconstruction: an experimental study using radiostereometry

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Distal radioulnar joint stabilization with open foveal reinsertion versus tendon graft reconstruction : an experimental study using radiostereometry. / Thillemann, Janni Kjærgaard; De Raedt, Sepp; Hansen, Torben Bæk; Munk, Bo; Stilling, Maiken.

In: Journal of experimental orthopaedics, Vol. 8, No. 1, 10, 12.2021.

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@article{b0c73ea8eb6b4d23b50d160fbf59dfc3,
title = "Distal radioulnar joint stabilization with open foveal reinsertion versus tendon graft reconstruction: an experimental study using radiostereometry",
abstract = "Purpose: Symptomatic instability of the distal radioulnar joint (DRUJ) caused by lesion of the Triangular Fibrocartilage Complex (TFCC) can be treated with a number of surgical techniques. Clinical examination of DRUJ translation is subjective and limited by inter-observer variability. The aim of this study was to compare the stabilizing effect on DRUJ translation with two different surgical methods using the Piano-key test and a new precise low-dose, non-invasive radiostereometric imaging method (AutoRSA). Methods: In a randomized experimental study we evaluated the DRUJ translation in ten human cadaver arms (8 males, mean age 78 years) after cutting the proximal and distal TFCC insertions, and after open surgical TFCC reinsertion (n = 5) or TFCC reconstruction using a palmaris longus tendon graft ad modum Adams (n = 5). The cadaver arms were mounted in a custom-made fixture for a standardized Piano-key test. Radiostereometric images were recorded and AutoRSA software was used for image analyses. Standardised anatomical axes and coordinate systems of the forearm computer tomography bone models were applied to estimate DRUJ translation after TFCC lesions and after surgical repair. Results: The DRUJ translation after cutting the proximal and distal TFCC insertions was 2.48 mm (95% CI 1.61; 3.36). Foveal TFCC reinsertion reduced DRUJ translation by 1.78 mm (95% CI 0.82; 2.74, p = 0.007), while TFCC reconstruction reduced DRUJ translation by 1.01 mm (95% CI -1.58; 3.60, p = 0.17). Conclusion: In conclusion, foveal TFCC reinsertion significantly decreased DRUJ translation while the stabilizing effect of Adams TFCC reconstruction was heterogeneous. This supports the clinical recommendation of TFCC reinsertion in patients suffering from symptomatic DRUJ instability due to acute fovea TFCC lesions.",
keywords = "Distal radioulnar joint, Instability, Radiostereometry, Reconstruction, Surgery, Triangular fibrocartilage complex",
author = "Thillemann, {Janni Kj{\ae}rgaard} and {De Raedt}, Sepp and Hansen, {Torben B{\ae}k} and Bo Munk and Maiken Stilling",
note = "Funding Information: This study was supported by the Innovation Fund Grant 69–2013-1, “Transforming radiological technology for assessment of implant fixation: from research tool to clinical application”, The Danish Rheumatism Association and the Health Research Fund of Central Denmark Region and Health Research Fund of Central Denmark Region, Aarhus University. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = dec,
doi = "10.1186/s40634-021-00329-y",
language = "English",
volume = "8",
journal = "Journal of experimental orthopaedics",
issn = "2197-1153",
publisher = "Springer International Publishing AG",
number = "1",

}

RIS

TY - JOUR

T1 - Distal radioulnar joint stabilization with open foveal reinsertion versus tendon graft reconstruction

T2 - an experimental study using radiostereometry

AU - Thillemann, Janni Kjærgaard

AU - De Raedt, Sepp

AU - Hansen, Torben Bæk

AU - Munk, Bo

AU - Stilling, Maiken

N1 - Funding Information: This study was supported by the Innovation Fund Grant 69–2013-1, “Transforming radiological technology for assessment of implant fixation: from research tool to clinical application”, The Danish Rheumatism Association and the Health Research Fund of Central Denmark Region and Health Research Fund of Central Denmark Region, Aarhus University. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/12

Y1 - 2021/12

N2 - Purpose: Symptomatic instability of the distal radioulnar joint (DRUJ) caused by lesion of the Triangular Fibrocartilage Complex (TFCC) can be treated with a number of surgical techniques. Clinical examination of DRUJ translation is subjective and limited by inter-observer variability. The aim of this study was to compare the stabilizing effect on DRUJ translation with two different surgical methods using the Piano-key test and a new precise low-dose, non-invasive radiostereometric imaging method (AutoRSA). Methods: In a randomized experimental study we evaluated the DRUJ translation in ten human cadaver arms (8 males, mean age 78 years) after cutting the proximal and distal TFCC insertions, and after open surgical TFCC reinsertion (n = 5) or TFCC reconstruction using a palmaris longus tendon graft ad modum Adams (n = 5). The cadaver arms were mounted in a custom-made fixture for a standardized Piano-key test. Radiostereometric images were recorded and AutoRSA software was used for image analyses. Standardised anatomical axes and coordinate systems of the forearm computer tomography bone models were applied to estimate DRUJ translation after TFCC lesions and after surgical repair. Results: The DRUJ translation after cutting the proximal and distal TFCC insertions was 2.48 mm (95% CI 1.61; 3.36). Foveal TFCC reinsertion reduced DRUJ translation by 1.78 mm (95% CI 0.82; 2.74, p = 0.007), while TFCC reconstruction reduced DRUJ translation by 1.01 mm (95% CI -1.58; 3.60, p = 0.17). Conclusion: In conclusion, foveal TFCC reinsertion significantly decreased DRUJ translation while the stabilizing effect of Adams TFCC reconstruction was heterogeneous. This supports the clinical recommendation of TFCC reinsertion in patients suffering from symptomatic DRUJ instability due to acute fovea TFCC lesions.

AB - Purpose: Symptomatic instability of the distal radioulnar joint (DRUJ) caused by lesion of the Triangular Fibrocartilage Complex (TFCC) can be treated with a number of surgical techniques. Clinical examination of DRUJ translation is subjective and limited by inter-observer variability. The aim of this study was to compare the stabilizing effect on DRUJ translation with two different surgical methods using the Piano-key test and a new precise low-dose, non-invasive radiostereometric imaging method (AutoRSA). Methods: In a randomized experimental study we evaluated the DRUJ translation in ten human cadaver arms (8 males, mean age 78 years) after cutting the proximal and distal TFCC insertions, and after open surgical TFCC reinsertion (n = 5) or TFCC reconstruction using a palmaris longus tendon graft ad modum Adams (n = 5). The cadaver arms were mounted in a custom-made fixture for a standardized Piano-key test. Radiostereometric images were recorded and AutoRSA software was used for image analyses. Standardised anatomical axes and coordinate systems of the forearm computer tomography bone models were applied to estimate DRUJ translation after TFCC lesions and after surgical repair. Results: The DRUJ translation after cutting the proximal and distal TFCC insertions was 2.48 mm (95% CI 1.61; 3.36). Foveal TFCC reinsertion reduced DRUJ translation by 1.78 mm (95% CI 0.82; 2.74, p = 0.007), while TFCC reconstruction reduced DRUJ translation by 1.01 mm (95% CI -1.58; 3.60, p = 0.17). Conclusion: In conclusion, foveal TFCC reinsertion significantly decreased DRUJ translation while the stabilizing effect of Adams TFCC reconstruction was heterogeneous. This supports the clinical recommendation of TFCC reinsertion in patients suffering from symptomatic DRUJ instability due to acute fovea TFCC lesions.

KW - Distal radioulnar joint

KW - Instability

KW - Radiostereometry

KW - Reconstruction

KW - Surgery

KW - Triangular fibrocartilage complex

UR - http://www.scopus.com/inward/record.url?scp=85100453270&partnerID=8YFLogxK

U2 - 10.1186/s40634-021-00329-y

DO - 10.1186/s40634-021-00329-y

M3 - Journal article

C2 - 33543376

AN - SCOPUS:85100453270

VL - 8

JO - Journal of experimental orthopaedics

JF - Journal of experimental orthopaedics

SN - 2197-1153

IS - 1

M1 - 10

ER -