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Niebauer trapeziometacarpal arthroplasty.
B D Adams1, R S Unsell, P McLaughlin
1Department of Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock.
The Journal of Hand Surgery
|May 1, 1990
Summary
The Niebauer implant for trapeziometacarpal osteoarthritis shows mixed pain relief and functional outcomes, with no significant improvement in strength or opposition compared to non-operative thumbs. Surgeons should consider ease of implantation over expected clinical benefits.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Biomaterials Science
Background:
- Advanced osteoarthritis of the trapeziometacarpal (TMC) joint significantly impacts hand function and quality of life.
- Niebauer implant arthroplasty is a surgical option for treating severe TMC joint osteoarthritis.
Purpose of the Study:
- To evaluate the clinical outcomes and radiographic findings of Niebauer implant arthroplasty for advanced TMC joint osteoarthritis.
- To compare the effectiveness of Niebauer implants with non-operative management and other silicone trapezium implants.
Main Methods:
- Retrospective review of 22 Niebauer implant arthroplasties in 18 patients with advanced TMC joint osteoarthritis.
- Mean follow-up of 2.4 years, assessing pain relief, functional status, thumb strength, opposition, and radiographic parameters.
- Clinical and radiographic examinations to evaluate implant stability, breakage, and bone response.
Main Results:
- Good pain relief reported by 13 patients; functional status improved in 6 patients.
- Thumb abduction and strength were similar to non-operative hands; full opposition decreased from 93% to 68%.
- Asymptomatic subluxation (<50%) occurred in 23%, symptomatic instability (>75% subluxation) in 9%; no implant breakage or silicone synovitis observed.
Conclusions:
- Niebauer implant arthroplasty provides variable pain relief and functional outcomes for TMC joint osteoarthritis.
- The implant does not demonstrate superior results compared to other silicone trapezium implants.
- Surgical choice should be based on surgeon preference for ease of implantation rather than anticipated superior clinical outcomes.