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Total wrist arthroplasty using the Universal 2 prosthesis.

Syam P K Morapudi1, William J Marlow, Daniel Withers

  • 1Macclesfield District General Hospital, Macclesfield, Cheshire, United Kingdom.

Journal of Orthopaedic Surgery (Hong Kong)
|December 21, 2012
PubMed
Summary
This summary is machine-generated.

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Total wrist arthroplasty (TWA) with the Universal 2 prosthesis significantly improved wrist function and range of motion. This study found reduced instability and loosening, indicating a favorable outcome for patients with arthritis.

Area of Science:

  • Orthopedic surgery
  • Biomaterials science

Background:

  • Rheumatoid arthritis and post-traumatic arthritis can severely impair wrist function.
  • Total wrist arthroplasty (TWA) is a surgical option for end-stage wrist arthritis.

Purpose of the Study:

  • To evaluate the clinical and radiographic outcomes of 21 total wrist arthroplasties (TWA) performed using the Universal 2 prosthesis.
  • To assess the efficacy of the Universal 2 prosthesis in improving pain, function, and range of motion in patients with wrist arthritis.

Main Methods:

  • Twenty-one TWAs were performed using the Universal 2 prosthesis in patients with rheumatoid arthritis (n=19) or post-traumatic arthritis (n=2).
  • Pre- and post-operative Disabilities of the Arm, Shoulder and Hand (DASH) and patient-rated wrist evaluation (PRWE) scores were used to assess pain and function.

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  • Range of motion, stability, neurovascular status, and radiographic parameters (alignment, fit, loosening) were evaluated.

    • Main Results:

    • Significant improvements in range of motion, DASH, and PRWE scores were observed post-TWA.
    • Complications included restricted range of motion (n=2), palmar bony bridge (n=1), and extensor pollicis longus rupture (n=1).
    • Radiographs showed no implant loosening, migration, or malalignment, and no osteonecrosis.

    Conclusions:

    • The Universal 2 TWA demonstrated significant improvements in wrist range of motion and functional outcomes.
    • This prosthesis offers reduced rates of early joint instability, dislocation, and implant loosening compared to prior designs.
    • The cementless design and small implant size contribute to reduced bone loss and osteonecrosis.