New concept for total wrist replacement.

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Materials science

Background:

• Wrist prostheses historically show poorer clinical outcomes compared to hip or knee replacements.
• Osteoarthritis significantly impacts wrist function and patient quality of life.

Purpose of the Study:

• To evaluate the long-term clinical outcomes of a novel uncemented modular wrist prosthesis.
• To assess the prosthesis's stability, mobility, pain relief, and grip strength in patients with osteoarthritis.

Main Methods:

• Developed a novel uncemented modular wrist prosthesis featuring screw fixation, metal-on-metal coupling, and ball-and-socket articulation.
• Implanted the prosthesis in eight patients undergoing wrist arthrodesis for osteoarthritis.
• Followed patients for 7 to 9 years to assess outcomes and implant performance.

Main Results:

• The prosthesis provided good stability and mobility with satisfactory pain relief and grip strength.
• No instances of luxation, metacarpal fracture, cut-out, or mechanical implant failure were observed.
• Two cases of distal screw loosening required revision; one early inflammation and one late infection led to revision to arthrodesis.

Conclusions:

• The novel wrist prosthesis demonstrates promising long-term results for osteoarthritis, with potential for improved joint preservation.
• Proposed modifications include refining screw design and surgical technique for enhanced implant durability and reduced complication rates.
• Further research and refinement of implant design and surgical techniques are warranted to optimize wrist arthroplasty outcomes.