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- Talk
- UK
Arthroplasty in the Hand and Wrist - the Current State of Play
Description
The presentation outlines the advancements in arthroplasty for the hand and wrist, focusing primarily on the thumb's carpometacarpal (CMC) joint. Sumedh Talwalkar discusses the traditional trapeziectomy approach, noting its long history and limitations, such as thumb shortening and reduced grip strength. The talk highlights contemporary innovations in joint replacement technologies, including the development of dual-mobility cones and the transition from saddle to ball-and-socket designs to improve stability and reduce dislocation risks.
Talwalkar mentions the variety of implants, issues surrounding their designs—including complications like intraprosthetic dislocations and polyethylene wear—and the need for meticulous surgical techniques. He also references the 85-95% survivorship rates for various prostheses over a decade, alongside the enhanced rehabilitation outcomes subsequent to total joint replacements when compared to traditional methods. For proximal interphalangeal (PIP) joint replacements, he covers the challenges of current prosthetic designs, such as mechanical disadvantages leading to loosening and the importance of careful preoperative planning and execution.
The final sections address total wrist arthroplasty, discussing the slow progression in this area due to complications observed in earlier prosthetic models but also presenting contemporary options that show promise. Talwalkar emphasizes the necessity of structured clinical governance in performing these complex procedures, particularly with a focus on patient-specific factors affecting outcomes.