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[The WEKO finger joint prosthesis].
1Orthopädische Abteilung, Marienhospital Gelsenkirchen. egoerz@st-augustinus.de
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|March 4, 2005
Summary
The WEKO prosthesis for rheumatoid arthritis showed initial promise but experienced significant failure rates, including loosening and breakage, leading to revisions. A second-generation design aimed to improve stability and osseointegration.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomedical Engineering
Background:
- Rheumatoid arthritis frequently destroys metacarpophalangeal joints, necessitating reconstructive surgery.
- The WEKO prosthesis was developed to restore joint stability and function in affected patients.
Purpose of the Study:
- To evaluate the long-term clinical and radiographic outcomes of the first-generation WEKO prosthesis.
- To identify failure modes and inform the development of an improved prosthesis design.
Main Methods:
- A retrospective follow-up study of 48 patients (74 prostheses) operated on between 1993 and 2003.
- Clinical and radiographic examinations were performed on 43 patients (65 prostheses).
Main Results:
- A 16.2% failure rate was observed, including prosthesis loosening, sleeve loosening, and implant breakage.
- Twelve implants (16.2%) required removal.
- Postoperative range of motion decreased from 0/0/90 degrees to 0/10/70 degrees at follow-up.
Conclusions:
- The initial WEKO prosthesis demonstrated suboptimal long-term durability, with significant failure rates impacting joint function.
- Patient satisfaction declined over time due to disease progression and implant issues.
- A second-generation WEKO prosthesis was designed to enhance rotational stability and osseointegration, addressing observed failure modes.