Foreign body reaction after trapeziectomy and Dacron interposition

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Rheumatology

Background:

• Trapeziometacarpal osteoarthritis is a common condition affecting the thumb base.
• Dacron interposition arthroplasty has been used as a treatment option.
• Foreign body reactions to implants can lead to complications.

Purpose of the Study:

• To evaluate patients treated with trapeziectomy and Dacron interposition.
• To describe the incidence and characteristics of foreign body reactions associated with Dacron implants.

Main Methods:

• Retrospective review of 10 patients (11 hands) who underwent trapeziectomy and Dacron interposition arthroplasty between 2004 and 2010.
• Clinical examination, DASH score, VAS for pain and satisfaction, grip, and pinch strength assessment.
• Radiographic and histological analysis for foreign body reactions.

Main Results:

• Two patients (2 hands) required implant removal due to foreign body reactions, confirmed histologically with giant cells.
• Seven out of nine remaining hands showed radiological signs of foreign body reaction, including bone erosion.
• Three patients experienced severe reactions; mean DASH score was 32, VAS for pain 1.6, and satisfaction 8.8.

Conclusions:

• Dacron interposition arthroplasty is associated with a significant incidence of foreign body reactions, including bone erosion.
• The use of Dacron implants in this context has been discontinued.
• Close monitoring of patients with existing Dacron implants is recommended.