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Preliminary results of total wrist arthroplasty using the RWS Prosthesis.
1Department of Orthopaedics, Leiden University Medical Centre, The Netherlands.
Journal of Hand Surgery (Edinburgh, Scotland)
|January 18, 2003
Summary
Wrist prostheses significantly improved pain and motion in rheumatoid arthritis patients. However, long-term fixation and distal ulna management presented challenges, with some cases showing loosening or failure.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomedical Engineering
Background:
- Rheumatoid arthritis frequently affects the wrist, causing pain and functional limitations.
- Wrist arthroplasty is a treatment option for end-stage wrist disease in rheumatoid arthritis.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of wrist prostheses in patients with rheumatoid arthritis.
- To identify potential complications and areas for improvement in wrist arthroplasty.
Main Methods:
- A retrospective study of 29 wrist prostheses implanted in patients, predominantly those with rheumatoid arthritis.
- Follow-up averaged 4 years, assessing pain, range of motion, and using Meuli's wrist score.
- Radiological evaluation for loosening and failure was performed.
Main Results:
- Significant improvements in pain and range of motion were observed.
- Meuli's wrist score indicated excellent or good outcomes in 22 out of 27 assessable patients.
- Three radiological failures and one revision occurred; 11 prostheses showed signs of possible loosening.
Conclusions:
- Wrist prostheses can provide significant functional benefits for rheumatoid arthritis patients.
- Challenges remain regarding distal ulna management and long-term carpal component fixation.
- Further research is needed to optimize implant design and surgical techniques for improved longevity.