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Intermediate and Long-Term Outcomes of the Universal 2 Total Wrist Replacement
Adam Truss1, Geraint Morris1, Seif Sawalha2
1Department of Trauma and Orthopaedics, East Cheshire NHS Trust, Macclesfield, United Kingdom.
Journal of Wrist Surgery
|September 19, 2024
Summary
Total wrist replacement (TWR) using the Universal 2 prosthesis showed good short-term results for debilitating wrist arthritis. However, long-term data indicate continued issues with implant failure and instability, necessitating revision or fusion in a significant number of cases.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Reconstructive surgery
Background:
- Wrist arthritis causes severe pain and functional disability.
- Total wrist replacement (TWR) is an option after conservative treatments fail.
- The Universal 2 prosthesis is one design for TWR, aiming to reduce complications.
Purpose of the Study:
- To present the long-term survival data of the Universal 2 total wrist replacement (TWR) prosthesis.
- To evaluate the long-term functional outcomes and implant survivorship.
- To assess the durability of the Universal 2 implant in patients with wrist arthritis.
Main Methods:
- A cohort of 19 patients (21 TWRs) using the Universal 2 prosthesis was followed.
- Outcome data (PRWE, DASH scores) were collected at short, intermediate, and long-term intervals.
- Kaplan-Meier survival analysis and nonparametric tests were used to analyze data.
Main Results:
- At long-term follow-up, 7 of 21 TWRs required revision or fusion.
- Kaplan-Meier analysis showed a median survival of 12.9 years and 10-year survival of 68.1%.
- Patient-reported outcomes showed significant improvement at short and intermediate terms, but not long-term.
Conclusions:
- The Universal 2 prosthesis offers reasonable TWR outcomes for debilitating arthritis.
- Despite initial positive results, long-term follow-up reveals persistent implant failure and instability.
- Further investigation into the long-term performance and potential design modifications is warranted.
