Related Experiment Videos
Total wrist arthroplasty. Experience with Swanson flexible silicone implants, 1982-1988
1Department of Orthopedic Surgery, Odense University Hospital, Denmark.
Summary
Silicone rubber arthroplasty offers a useful range of motion and pain relief for severe wrist arthritis. However, complications like subsidence and fracture necessitate careful patient selection for optimal outcomes.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomaterials Science
Background:
- Rheumatoid arthritis frequently causes severe wrist destruction, necessitating surgical intervention.
- Silicone rubber arthroplasty is a treatment option for end-stage wrist disease.
- Evaluating long-term outcomes of silicone wrist arthroplasty is crucial for clinical decision-making.
Purpose of the Study:
- To assess the long-term results of silicone rubber arthroplasty for wrist arthritis.
- To identify predictors of failure in silicone wrist implants.
Main Methods:
- Retrospective study of 18 patients (19 wrists) undergoing silicone rubber arthroplasty.
- Mean follow-up of five years.
- Clinical assessment of pain, range of motion (ROM), and functional outcomes; radiological evaluation for subsidence and fracture.
Main Results:
- Good supination and pronation were achieved without pain in most patients.
- Mean radiocarpal ROM was 39 degrees (0-70 degrees).
- Severe subsidence occurred in all long-term follow-ups (>2 years); prosthetic fracture in 26% of cases.
- 16 wrists rated as good by patients, with pain relief in all but two.
Conclusions:
- Silicone spacers provide a useful range of motion and pain relief for severe wrist arthritis.
- High rates of subsidence and fracture are significant concerns.
- Preoperative alignment, postoperative ROM >50 degrees, and extensor tendon rupture predict implant failure.