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[Wrist joint arthroplasty: results after 41 prostheses]
1Handchirurgie, Orthopädische Chirurgie München, München. stephanie.strunk@ocm-muenchen.de
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|February 4, 2009
Summary
Wrist arthroplasty offers pain relief for rheumatoid arthritis patients but carries a high complication risk. Careful patient selection is crucial for successful outcomes, as results vary significantly between prosthesis types.
Area of Science:
- Orthopedic surgery
- Rheumatology
- Biomedical engineering
Background:
- Wrist arthroplasty's efficacy is debated due to high complication rates.
- Monitoring outcomes of different prostheses is essential, even with limited case numbers.
Purpose of the Study:
- To evaluate wrist joint arthroplasty as a treatment for rheumatoid arthritis.
- To compare the outcomes of different wrist prosthesis types.
Main Methods:
- Retrospective analysis of 41 wrist joint prostheses (Meuli, BIAX, Universal 2) implanted between 1992-2005.
- Patient-reported outcomes via DASH score questionnaire, clinical evaluation, and X-rays.
- Follow-up ranged from 1 to 14 years (mean 5.3 years).
Main Results:
- 31 of 38 patients reported satisfaction with the surgical outcome.
- Significant pain reduction was achieved in most patients.
- Complications occurred in 6 prostheses, including 4 dislocations; 3 required removal and arthrodesis.
Conclusions:
- Wrist arthroplasty can effectively reduce pain in selected patients, particularly those with rheumatoid arthritis.
- Preoperative factors like bony malposition and tendon dysfunction negatively impact results.
- While pain relief is a benefit, the complication risk remains higher than with arthrodesis.