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Total wrist replacement: a retrospective comparative study.

William Cooney1, Jennifer Manuel, John Froelich

  • 1Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.

Journal of Wrist Surgery
|November 2, 2013
PubMed
Summary
This summary is machine-generated.

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This study compared three total wrist arthroplasty (TWA) implants, finding that resurfacing designs generally offer good pain relief and functional motion, especially with improved fixation.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Reconstructive Surgery

Background:

  • Total wrist arthroplasty (TWA) is an increasingly utilized surgical option for managing debilitating wrist arthritis.
  • Various implant designs exist, each with distinct biomechanical properties and surgical approaches.

Purpose of the Study:

  • To compare the clinical outcomes, radiographic results, and complication rates of three distinct total wrist implant designs.
  • To evaluate patient-reported functional improvements following TWA.

Main Methods:

  • A retrospective review of 46 total wrist arthroplasties (Biaxial, Universal 2, Re-Motion) in 39 patients.
  • Assessment included clinical outcomes, radiographic analysis, complication review, and functional scores (Mayo, PRWE, DASH).
  • Follow-up averaged 6 years, encompassing both rheumatoid and posttraumatic arthritis cases.
Keywords:
arthroplastyjointrheumatoidtotal wrist

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Main Results:

  • Nine implant failures occurred, primarily due to distal component loosening and instability.
  • Successful cases demonstrated improved range of motion (flexion/extension) and grip strength.
  • Mayo wrist scores significantly improved from 40 to 76 postoperatively.
  • Resurfacing designs (Universal 2, Re-Motion) showed better outcomes (lower DASH scores) compared to the resectional arthroplasty (Biaxial).

Conclusions:

  • Total wrist arthroplasty provides effective pain relief and functional restoration in over 80% of patients.
  • Resurfacing implant designs achieve high success rates (97%), particularly when distal component fixation is optimized.
  • Minimizing distal radius resection correlates with superior surgical outcomes.