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Twenty-Year Experience With Primary Distal Radioulnar Joint Arthroplasty From a Single Institution
Asgeir Amundsen1, Marco Rizzo2, Richard A Berger2
1Department of Orthopedic Surgery, Østfold Hospital Trust, Kalnes, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
The Journal of Hand Surgery
|May 13, 2022
Summary
Distal radioulnar joint arthroplasty improves wrist function, but reoperation rates are high. Semi-constrained implants offer better lifting capacity than ulnar head prostheses (UHP), though both implant types show functional gains.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Musculoskeletal research
Background:
- Implant arthroplasty for the distal radioulnar joint (DRUJ) is increasingly utilized.
- Existing literature primarily comprises small patient series, necessitating studies with longer follow-up periods.
Purpose of the Study:
- To evaluate the long-term outcomes of distal radioulnar joint arthroplasty using two common implant types.
- To compare the functional results and reoperation rates between semi-constrained total joint arthroplasty and ulnar head prosthesis (UHP).
Main Methods:
- A retrospective analysis of a patient registry from 2000 to 2019.
- Inclusion of 53 semi-constrained total joint arthroplasties and 102 UHPs, with follow-up including radiographic and physical examinations, Mayo Wrist Scores, pain assessment, range of motion, and grip strength.
- Recording of reoperations and calculation of implant survival rates using Kaplan-Meier curves.
Main Results:
- Both implant groups demonstrated improvements in grip strength and Mayo Wrist Score, with 76% of patients experiencing pain reduction.
- The semi-constrained group showed improved supination and superior lifting capacity compared to the UHP group.
- Unadjusted reoperation rates were 23% for semi-constrained implants and 34% for UHPs; 5-year survival rates were 94% and 87%, respectively. Risk factors for reoperation included younger age, prior wrist surgery, ulnar shortening, and wrist fusion.
Conclusions:
- Distal radioulnar joint arthroplasty effectively enhances functional outcomes for patients experiencing wrist pain and instability.
- While reoperations are common, the semi-constrained implant shows advantages in lifting capacity.
- Bilateral implants yielded results comparable to unilateral ones, suggesting broader applicability.
