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Background: Wrist arthroplasty is increasingly offered to patients with symptomatic wrist arthritis as an alternative to wrist arthrodesis. The purpose of this study was to present our outcomes with the ReMotion™ wrist arthroplasty in a consecutive series of patients with wrist arthritis from non-inflammatory conditions. Methods: Thirteen (eight women, nine dominant wrists) patients, 68 (44-85) years of age with advanced radiocarpal arthritis due to SLAC/SNAC (11) and Kienbock disease (2) had a ReMotion™ (Stryker, Michigan, USA) wrist arthroplasty implanted, and were prospectively followed for 7 (4-9) years. The outcome measures included patient-rated wrist and hand evaluation (PRWHE) score, disabilities of the arm, shoulder and hand questionnaire (QuickDASH) score, visual analogue pain score (0-10) on the radial and ulnar aspect of the wrist at rest (VASrR/VASuR) and activity (VASrA/VASuA), active wrist range of motion (AROM) including flexion, extension, ulnar and radial deviation, pronation and supination and grip and key-pinch strength measured preoperatively and at yearly follow-ups by independent hand therapists. Results: Six patients had ten re-operations during the follow-up including four revisions to a new arthroplasty. Four were considered loose at follow-up. A significant reduction in PRWHE (63 to 12), radial pain at activity (6 to 1) and increased pronation (85° v 90°) was observed. Conclusions: We found a high complication and reoperation rate, two out of 13 had no complications or reoperations. The ReMotion™ arthroplasty should be used with caution in non-inflammatory wrist patients and the patients followed closely. A high reoperation and revision rate can be expected, and surgeons familiar with revision arthroplasty procedures should perform the surgery. Level of Evidence: Level II (Therapeutic).
Assuntos
Prótese Articular , Articulação do Punho , Humanos , Feminino , Idoso , Articulação do Punho/cirurgia , Pessoa de Meia-Idade , Masculino , Idoso de 80 Anos ou mais , Prótese Articular/efeitos adversos , Adulto , Amplitude de Movimento Articular , Artroplastia de Substituição/instrumentação , Artroplastia de Substituição/métodos , Artroplastia de Substituição/efeitos adversos , Estudos Prospectivos , Resultado do Tratamento , Artrite/cirurgia , Avaliação da Deficiência , Força da Mão , Medição da Dor , Desenho de PróteseRESUMO
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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The profound changes in global SO2 emissions over the last decades have affected atmospheric composition on a regional and global scale with large impact on air quality, atmospheric deposition and the radiative forcing of sulfate aerosols. Reproduction of historical atmospheric pollution levels based on global aerosol models and emission changes is crucial to prove that such models are able to predict future scenarios. Here, we analyze consistency of trends in observations of sulfur components in air and precipitation from major regional networks and estimates from six different global aerosol models from 1990 until 2015. There are large interregional differences in the sulfur trends consistently captured by the models and observations, especially for North America and Europe. Europe had the largest reductions in sulfur emissions in the first part of the period while the highest reduction came later in North America and East Asia. The uncertainties in both the emissions and the representativity of the observations are larger in Asia. However, emissions from East Asia clearly increased from 2000 to 2005 followed by a decrease, while in India a steady increase over the whole period has been observed and modelled. The agreement between a bottom-up approach, which uses emissions and process-based chemical transport models, with independent observations gives an improved confidence in the understanding of the atmospheric sulfur budget.
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Raman spectra of solid nitric acid hydrates (NAM, alpha- and beta-NAD, alpha- and beta-NAT, and NAP) are obtained in the low-frequency region 20-175 cm(-1) where phonon bands show characteristic patterns. This fingerprint information, intimately related to the structure and symmetry of the unit cell, is well suited for observation of phase changes in solid nitric acid hydrates and allows the distinction of mixtures of different hydrate phases. The low-frequency spectra are correlated with the spectra of the respective symmetric NO stretching vibration (1000-1080 cm(-1)), with literature data, and with X-ray diffraction patterns.
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The complex index of refraction of aqueous methanesulfonic acid (MSA) at room temperature and at concentrations of 1-70 wt. % is presented. The complex index of refraction is obtained in the entire wave-number region from the mid infrared to the ultraviolet-visible regions. An analysis of the infrared spectra reveals a single absorption band, which makes it possible to identify MSA in aqueous H2SO4. The surface tension of 1-99-wt. % aqueous MSA from room temperature to approximately 263 K, depending on the concentration of MSA, is reported. A polynomial parameterization of the surface tension in terms of acid weight fraction and temperature is presented.