Anne J Spaans1, E J M Leonieke van Heeswijk2, Dorothee E Arnold2, Annechien Beumer2. 1. Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Pathology, Amphia Hospital, Breda, The Netherlands. Electronic address: annespaans@gmail.com. 2. Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Pathology, Amphia Hospital, Breda, The Netherlands.
Abstract
PURPOSE: To report the incidence of foreign body reactions associated with placement of a polyethylene mesh implant in patients treated with trapiezectomy for trapeziometacarpal osteoarthritis. METHODS: Between November 2008 and September 2012, 70 hands in 66 adults with stage IV trapeziometacarpal osteoarthritis had a trapiezectomy with interposition of a spacer made of polyethylene terephthalate mesh (Anchois Ligastic, Orthomed SA, St Jeannet, France). Out of these 70 implants, 8 implants (11%) in 8 patients (mean age, 60 y; range, 49-75 y) were removed because of persistent swelling, synovitis, and pain. RESULTS: The mean interval between primary and revision surgery was 14 (range, 5-27) months. Histological analysis in all cases showed a foreign body giant cell reaction. Two hands showed bone resorption or carpal bone cysts similar to silicone particle synovitis. The cysts resolved after implant removal and bone grafting. CONCLUSIONS: In the light of these results and the available literature, we recommend not using this material for interposition in the treatment of osteoarthritis of the trapeziometacarpal joint. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PURPOSE: To report the incidence of foreign body reactions associated with placement of a polyethylene mesh implant in patients treated with trapiezectomy for trapeziometacarpal osteoarthritis. METHODS: Between November 2008 and September 2012, 70 hands in 66 adults with stage IV trapeziometacarpal osteoarthritis had a trapiezectomy with interposition of a spacer made of polyethylene terephthalate mesh (Anchois Ligastic, Orthomed SA, St Jeannet, France). Out of these 70 implants, 8 implants (11%) in 8 patients (mean age, 60 y; range, 49-75 y) were removed because of persistent swelling, synovitis, and pain. RESULTS: The mean interval between primary and revision surgery was 14 (range, 5-27) months. Histological analysis in all cases showed a foreign body giant cell reaction. Two hands showed bone resorption or carpal bone cysts similar to silicone particle synovitis. The cysts resolved after implant removal and bone grafting. CONCLUSIONS: In the light of these results and the available literature, we recommend not using this material for interposition in the treatment of osteoarthritis of the trapeziometacarpal joint. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.