Total wrist arthroplasty in patients with rheumatoid arthritis
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Updated: Aug 31, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Sebastian Radmer1, Reimer Andresen, Martin Sparmann
1Department of Orthopedics and Rheumatic Surgery, Immanuel Hospital, Academic Teaching Hospital, Free University of Berlin, Berlin, Germany.
Purpose:
After very good midterm results with an uncemented total wrist arthroplasty we evaluated the long-term outcome in a retrospective study.
Methods:
Forty uncemented anatomic physiologic (APH, Implant-Service Vertreibs-GmbH, Hamburg, Germany) wrist prosthesis implantations performed in 40 patients were reviewed. The mean follow-up period was 52 months (range, 24-73 mo) and the following parameters were examined: radiographs, grip strength, range of motion, and patient's satisfaction.
Results:
After a good short-term outcome the results deteriorated with time. The following complications occurred: 2 infections, 3 implant failures, 2 prosthesis migrations, and 33 loosenings/dislocations. All patients (39 of 40) underwent revision surgery, and severe titanium wear in the soft tissues was found intraoperatively in all cases. It became clear that even in a non-weight-bearing joint such as the wrist, titanium alloy may wear and result in tissue metallosis when used as a bearing surface of the implant. As a salvage procedure the prosthesis was removed and an arthrodesis was performed in all patients.
Conclusions:
Because of the deterioration of the results including an unacceptable revision rate we currently do not consider the anatomic physiologic wrist prosthesis to be a suitable implant in patients with rheumatoid arthritis.