The development of a total wrist arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Preserving wrist motion is crucial for fine motor control of the hand and fingers.
• Significant wrist dysfunction limits daily activities and necessitates surgical intervention.
• Current treatments like soft tissue arthroplasty, carpectomy, or arthrodesis have limitations.

Purpose of the Study:

• To evaluate the efficacy of total wrist arthroplasty (TWA) in restoring wrist function.
• To assess pain relief, stability, and range of motion following TWA.
• To identify suitable candidates for TWA, particularly those facing significant functional loss with arthrodesis.

Main Methods:

• Total wrist joint prosthesis implantation, secured with methylmethacrylate cement.
• Removal of the navicular, lunate, and capitate head.
• Prosthesis designed for 90 degrees flexion-extension and 50 degrees radial-ulnar deviation.

Main Results:

• 17 total wrist arthroplasties performed in 14 patients with a maximum follow-up of 14 months.
• 15 out of 17 patients achieved a useful range of motion.
• All patients reported significant pain and deformity relief, enabling previously impossible tasks.

Conclusions:

• Total wrist arthroplasty can provide a pain-free, stable, and mobile wrist.
• The procedure offers a viable alternative for patients with advanced wrist disease where motion preservation is critical.
• TWA significantly improves functional capacity and quality of life for selected patients.