LEDA Ortho

Elbow

Upper Limb Trauma Specialists

Maia

MAÏA™ Carpometacarpal Prosthesis

Established in October 2013, LEDA Orthopaedics began life as a sales agency and quickly grew into a UK and European distributor with innovative suppliers from all over the world. Founding directors David Plane and Jon Bloy have over 30 years’ collective experience in the orthopaedic industry and a passion for the sector that shines through in their commitment to the business to this day. Read More…

Our Suppliers

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Latest News

Elsevier non solus
Treatments for hand and wrist osteoarthritis

Arthritis is a condition that is likely to affect many of us in our lifetime, especially as we get older. A Versus Arthritis study from 2023 reports that there are roughly 10 million people in the UK living with osteoarthritis, with an estimated 350,000 being diagnosed with the condition each year. Given that osteoarthritis is more problematic when it affects joints that see regular use, let’s examine the treatment options available for osteoarthritis of the hand and wrist.

 

Defining wrist osteoarthritis

Osteoarthritis in the wrist causes the soft tissue lining the joints to break down. When this happens, the cartilage can no longer serve its protective function and the two ends of bone begin to rub together (distal radius/ulna and scaphoid/lunate/triquetral). The result can be pain and stiffness at the affected area, along with potential loss of movement and bone deformities. Arthritis in any form is also one of the main contributing factors in upper and lower extremity fractures, such as a distal radius fracture. Read ‘Common causes of upper extremity fractures’ for more information.

What’s the difference between arthritis and osteoarthritis?

Osteoarthritis is a degenerative form of arthritis which is caused by wear and tear from excessive use of the affected joints. It is also the most common type of arthritis. While there are many more types of arthritis that can affect the bones in the hand and wrist, the other common types include Rheumatoid arthritis and Psoriatic arthritis.

 

What areas does hand osteoarthritis commonly affect?

Although osteoarthritis is common in the hand due to the number of different bones, it rarely affects all parts of the hand and wrist equally. Instead, it most often affects the following joints in the hand:

  • The distal interphalangeal joint (DIP joint).
  • The proximal interphalangeal joint (PIP joint).
  • The trapeziometacarpal joint (TMC joint).
  • The carpometacarpal joint (CMC joint).
  • The tri-scaphoid joint (STT joint).

 

Treatment options for osteoarthritis of the hand and wrist

At the time of writing, it is still unclear what the root cause of osteoarthritis is. However, medical professionals like LEDA are aware of the factors that can make an individual more susceptible to hand and wrist osteoarthritis. This includes a patient’s age, weight, injuries, hobbies, sex, genetics, and any underlying joint health problems. Fortunately, there are many treatment options both orthopaedic and non-orthopaedic that surgeons may employ in cases of osteoarthritis.

MAIA CMCJ Replacement

One of the key areas in the hand that is susceptible to osteoarthritis are the carpometacarpal and trapeziometacarpal joint at the base of the thumb where it meets the wrist. This orthopaedic device from Group Lépine is a surgical treatment designed to restore motion and provide stability to the thumb. It consisted of a cup, neck, and stem which, when implanted, connect the two ends of bone at the joint. This is an osteotomy procedure as small pieces of bone at the joint must be removed to allow for the implantation of the MAIA device, which serves as a thumb joint replacement.

INCA STT Prosthesis

In cases of scaphotrapeziotrapezoid osteoarthritis, surgeons can use the INCA STT prosthesis for lasting treatment. The implant has been designed anatomically to make sure it fits perfectly with the anatomy of the patient’s joint surfaces. Stability is then encouraged through the stem shape, thereby requiring standard instrumentation to complete the procedure. This device can also achieve cementless fixation due to its double coating of porous titanium.

IMPLATE Wrist Arthrodesis Nails

The IMPLATE system from Skeletal Dynamics is intended for intramedullary wrist arthrodesis to restore strength and dexterity to the hand and wrist. This is an ideal treatment following a range of arthritis symptoms, including rheumatoid deformities, carpal instability, unremitting wrist pain, post septic arthritis, and more. A wrist arthrodesis plate such as this is effective at achieving. While the surgical technique for this implant contains more steps than most other hand and wrist orthopaedic devices, it can be the best option for patient quality of life. As well as osteoarthritis symptoms, IMPLATE can be used to treat trauma injuries (fractures) and congenital deformities.

Physical therapies

If it’s deemed the best course of action, there are a range of non-invasive treatment options for hand and wrist arthritis in the form of hand osteoarthritis exercises. These should focus on gentle movements that improve range of motion and help alleviate arthritis symptoms. Although the exact type of exercises prescribed will vary depending on the joints affected by the condition in that patient.

 

Orthopaedic devices for the treatment of osteoarthritis

LEDA Orthopaedics is a leading UK orthopaedic distributor committed to helping healthcare professionals deliver great patient outcomes. To this end, we work with suppliers all over the world with a focus on both the upper and lower extremities. One of the key areas these treatments target is osteoarthritis in the hand and wrist, as we know how many people it affects. Contact us to discuss our range of treatment options. Equally, if you are looking for one of our suppliers, we’re always happy to pass details over and establish working relationships.

March, 2024
Elsevier non solus
Understanding basal thumb osteoarthritis

Osteoarthritis is a common form of arthritis that affects millions of people in the UK. It can affect a range of bones in the body but tends to affect bones at key joint locations most heavily. As a result, osteoarthritis in the hand is very common due to the number of the bones and the frequent use that these joints see. This article discusses the main points around basal thumb osteoarthritis, including possible complications and treatment options.

 

What are the symptoms of thumb osteoarthritis?

The basal thumb joint is located where the bottom metacarpal bone of the thumb meets the trapezium bone in the wrist. This joint is vital for the use of the thumb as it’s involved in any movement of the digit. Osteoarthritis affecting the basal thumb joint can manifest in any of the following symptoms:

  • Diminished ability to twist, bend, grip, or pinch using the thumb.
  • Pain and swelling localised to the thumb and the surrounding area.
  • Loss of strength and movement that extends to the wrist.
  • In extreme cases, a bump at the base of the thumb caused by hyperextension of the MCP joint.

What causes basal thumb osteoarthritis?

At the time of writing, there is not a consensus on what causes arthritis in all its forms. However, there are a number of factors which are recognised as being contributary to the development and worsening of the condition. For osteoarthritis that affects the base of the thumb, this includes:

  • Patient age.
  • Height and weight (body mass index).
  • Jobs and hobbies (repetitive stress).
  • Certain metabolic diseases.
  • Biological sex.
  • Recent injuries or those with lasting repercussions.

Healthcare professionals should consider these factors when assessing whether a patient’s symptoms could be linked to osteoarthritis. This is also necessary to judge the severity of the condition and schedule appropriate treatments. Depending on the person, certain treatments could carry significantly more risk than they would otherwise. One of the most impactful effects of osteoarthritis is that it can be reduce bone stock and weaken joints. This leaves the patient more susceptible to bone injuries such as fractures, which can make it difficult to conduct osteotomies.

 

Treatment options for basal thumb osteoarthritis

As we’ve established, osteoarthritis in the thumb can cause significant disruption to someone’s everyday life due to the range of tasks we use our thumbs to complete on a daily basis. The following treatments are some of the options available to combat the effects of osteoarthritis in the thumb.

MAÏA Carpometacarpal Prosthesis

Joint replacement surgery can produce long lasting positive outcomes for patients. Through the removal of some or all of the thumb joint, an artificial implant can be inserted to restore motion and stabilise the thumb at the base. The MAÏA prosthesis from Group Lépine consists of a trapezial cup, offset neck, and metacarpal stem. Its dual mobility design is effective at reducing the chance of dislocation and ensuring stability. This system also comes with modern cannulated instrumentation to aid in surgical application.

Arthrodesis

Pain can be relieved by fusing joints in the thumb together. This can be achieved through the precise shaping of the trapezium and the hollowing of the metacarpal bone. Once the bone ends fit flush against each other, metal pins are used to hold the bones in place and allow them to knit together. It should be noted that this has the potential to be a lengthy open surgical procedure and so carries a relatively high complication rate. Although expertise and the use of leading arthrodesis screw and nail technology can reduce risk.

Movement restrictions

Efforts to limit movement and maintain positioning of the thumb can allow joints to repair themselves. A common way to do this, whilst also providing support and protection to the joint, is through the use of a hand or wrist splint. Although a medical professional may have to set the bones in the correct position first. They can also recommend exercises to help strengthen joints and improve function.

However, this treatment option may not be viable for every instance of osteoarthritis. For instance, a complex fracture could prevent blood flow from reaching the basal thumb joint thereby not allowing the bones to heal and making a splint an ineffective treatment.

 

Your UK orthopaedic distributor         

If you’re looking for a trusted third party to supply your clinic or hospital with arthritis implants, LEDA Orthopaedics can help. Our company is in collaboration with leading global suppliers of specialist orthopaedic implants for the treatment of osteoarthritis. Contact us and a member of our team will be happy to discuss how your needs in healthcare provision can be met.

March, 2024
Elsevier non solus
How does ulna shortening treat wrist pain?

An osteotomy of the ulna designed to shorten the bone can have many long-term positive patient outcomes. One of these is the removal of wrist pain and the restoration of a full range of movement in the joints of the hand and wrist. Surgeons should be aware of the pros and cons of an ulna shortening procedure so they can accurately advise patients on the treatment options which are best for them.

 

Causes of wrist pain in adults

Ongoing wrist pain that doesn’t go away can have a significant impact on someone’s quality of life. This is because the wrist typically flexes, undergoes strain, and carries weight on a regular basis. Pain in the wrist can also directly impact any actions that involve precise hand movements. The following are some of the most common causes of wrist pain in adults:

  • Fracture or sprain due to a sudden impact.
  • Repetitive stress or other long-term conditions such as carpal tunnel or arthritis.
  • Ulnar impaction syndrome. This causes the ulna to be longer than the radius, resulting in occasional contact with some of the smaller bones in the wrist.

In most cases, wrist pain is accompanied by swelling, redness, or loss of movement and grip strength which can make it easier to diagnose. With ulna wrist pain specifically, a clicking sound can also accompany movement as the bones come into contact.

 

What is the process of ulna shortening?

As the name suggests, the purpose of ulnar shortening osteotomy is to reduce the length of the ulna. This can result in a tightening of the triangular fibrocartilage complex (TFCC), interosseous membrane, and ulnocarpal ligaments. These outcomes are desirable as they can help remove the risk of the ulna interfering in the wrist joint in cases of ulnar impaction syndrome. This procedure can also reduce the amount of load that goes through the ulnar side of the wrist compared to the radius side, thereby reducing the likelihood of wrist pain returning in the future.

The first step in an ulna shortening procedure is to check that it is safe to conduct. Once all the necessary safety measures have been taken and proper instrumentation is prepared, it can follow these broad steps:

  • An incision is made to gain access to the ulna. Then a predetermined section of bone is removed to shorten it. This osteotomy can be done at either the distal or proximal end of the ulna.
  • The two pieces of bone must then be pulled together, ensuring the ulna is now in a favourable position.
  • Lastly, a forearm and wrist plating implant and orthopaedic screws must be applied to fix the bones in position. If the patient has suffered a fracture, this plate will be inserted at the fracture site. Otherwise, it will be positioned to provide maximum stability to the arm and wrist.

For more detail on the surgical procedure of ulna shortening, see Skeletal Dynamics’ Ulna Shortening System or the surgical procedure for the FREEFIX Forearm Plating System.

 

Ulna shortening as a treatment for wrist pain

An ulna shortening procedure should only be sought once more conservative treatment options for wrist pain have been exhausted. Examples include physical therapy or changing habits. When these fail, it will usually confirm the presence of an ulna bone that is pressing excessively on the wrist. The ulna shortening procedure is then more likely to result in long-term relief from wrist pain.

Specialised orthopaedic systems such as the FREEFIX Ulnar Shortening System give surgeons the flexibility to address patient specific pathologies. This device comes with options for both proximal and distal osteotomies, as well as accommodating compression screws and locking screws. Once internal fixation has been achieved, the ulna shortening plate maintains rotational stability in the forearm. For a more dedicated fracture reduction system, there’s the FREEFIX Forearm Plating System. This can be used to repair midshaft fractures of either the ulna or radius.

 

Orthopaedic devices for ulna shortening

LEDA are proud to work in collaboration with some of the leading orthopaedic suppliers across the globe in order to facilitate procedures such as ulna shortening. It’s one of our goals to bring innovations in orthopaedic surgery to the forefront of general medical use. As such, we don’t just supply devices for use in the upper extremities, we also distribute a range of implants for the treatment of lower extremity injuries complete with specialist instrumentation. This includes treatments for highly complex injuries, such as a pelvic fracture. Contact a member of the LEDA team today to get started.

March, 2024

The Founders

“When we established the company, we had one overriding goal: to provide exceptional levels of service to our customers and always enjoy what we do!”
David Plane
Managing Directors