Wrist Arthrodesis for Failed Total Wrist Arthroplasty

Area of Science:

• Orthopedic surgery
• Biomaterials science

Background:

• Failed total wrist arthroplasty presents treatment challenges, including implant revision, resection arthroplasty, and arthrodesis.
• Arthrodesis for failed total wrist arthroplasty has technical difficulties like restoring wrist height, achieving stable fixation, and ensuring bony fusion.

Purpose of the Study:

• To evaluate the radiographic outcomes of a surgical technique for converting failed total wrist arthroplasty to arthrodesis.
• To assess the safety and effectiveness of using a contoured structural allograft and wrist arthrodesis plate.

Main Methods:

• Retrospective review of 20 wrists in 18 patients undergoing conversion to arthrodesis.
• Utilized a contoured cancellous femoral head structural allograft and wrist arthrodesis plate.
• Supplemental demineralized bone matrix and allograft chips were used in 15 wrists.

Main Results:

• Nineteen of 20 wrists achieved bony fusion at a median of 4 months.
• One wrist experienced proximal plate loosening but still fused; revision surgery was performed later.
• Complications were minimal, including one superficial infection resolved with antibiotics.

Conclusions:

• The described technique for converting failed total wrist arthroplasty to arthrodesis is safe, effective, and versatile.
• This method successfully corrects wrist deformity, restores wrist height, and achieves stable fixation with a high fusion rate.
• Structural cancellous allograft effectively fills large defects, facilitating successful arthrodesis.