title: Porous polyurethaneurea (Artelon) joint spacer compared to trapezium resection and ligament reconstruction.
abstract: OBJECTIVE
  To examine outcomes and complications of the porous polyurethaneurea (Artelon; Small Bone Innovations, Morrisville, PA) spacer compared to traditional surgical treatment of trapeziectomy with ligament reconstruction and tendon interposition (LRTI).
  
  
  METHODS
  A retrospective chart review was undertaken of patients with carpometacarpal (CMC) arthritis who had either placement of an Artelon spacer or LRTI. Patients were brought back to clinic for interview and functional testing. Pain was graded using a visual analog scale. Grip and pinch strength, as well as range of motion at the first CMC joint, were measured. Nine-hole peg, Moberg pickup, and Jebson-Taylor tests were performed. Research and Development 36, Michigan Hand Outcomes, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaires were administered.
  
  
  RESULTS
  Thirty-eight patients received Artelon implants into the CMC joint, and 6 were lost to follow-up. Twelve of 32 patients (37%) required revision surgery with removal of implant and salvage arthroplasty. Twenty patients with nonrevised Artelon implants were compared with 10 patients who received 13 LRTI procedures. Patients with Artelon had significantly less pain improvement compared to those receiving the LRTI procedure. In addition, satisfaction was significantly decreased. There was no significant difference in any other functional or quality of life measures.
  
  
  CONCLUSIONS
  In our practice, use of the Artelon joint spacer resulted in an explantation rate of 37%. Due to these findings, we have abandoned its use for treatment of basilar thumb osteoarthritis. In contrast to previous studies, pain and satisfaction are worse in patients with intact Artelon spacers than those who had received LRTI.
authors.affiliation: Grand Rapids Medical Education Partners, Michigan State University Plastic Surgery Residency, Grand Rapids, MI, USA. andrewlblount@gmail.com
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Blount
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Armstrong
authors.forename: Frank
authors.initials: F
authors.lastname: Yuan
authors.forename: Scott D
authors.initials: SD
authors.lastname: Burgess
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D001178:Arthroplasty / Q000379:methods; D052737:Carpometacarpal Joints / Q000503:physiopathology / Q000601:surgery; D005260:Female; D018737:Hand Strength; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011140:Polyurethanes / Q000627:therapeutic use*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013812:Therapeutics; D013933:Thumb / Q000601:surgery; D051222:Trapezium Bone / Q000601:surgery*
chemical_list: D011140:Polyurethanes; C044690:polyetherurethane urea
keywords: Artelon; basilar joint osteoarthritis; ligament reconstruction with tendon interposition; thumb osteoarthritis; trapeziectomy