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Long-term outcomes of the Universal 2 total wrist arthroplasty
Alexander Tham1, Andrew Ross1, Jonathan Wright1
1Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK.
Aims:
The Universal 2 total wrist arthroplasty (TWA) aims to alleviate wrist pain and restore function. This study investigates the survival time, revision rate, complication rate, and performs radiological analysis on Universal 2 TWAs in the long term.
Methods:
Forty-seven Universal 2 TWA in 45 patients were performed between 2006 and 2014. Patient satisfaction, DASH score, complications, revision rate and radiological analysis of the TWA were recorded.
Results:
Mean follow-up was 11.7 years (range 2.5-17.6 years). There was significant improvement in post-operative DASH score (mean 58.3, SD 13) compared to preoperative DASH scores (mean 33, SD 20, p < 0.001). At latest follow-up, 65 % of patients would undergo the procedure, a reduction from 87 % at mid-term follow-up. On radiological analysis, 26 wrists had lucencies of at least one component. Complications occurred in 18 wrists (38 %). Eleven TWA (23 %) were revised at a mean 7.3 years post-operation (range 2.0-13.7 years). Mean survival of the implant was 13.6 years (12.2-15.0 years 95 % CI). Kaplan-Meier analysis identified no significant differences in survivorship between inflammatory arthritis (13.2 years, 11.5-14.9 years 95 % CI) and osteoarthritis (12.9 years, 11.0-14.8 years 95 % CI, p = 0.39).
Conclusion:
At long-term follow-up, the Universal 2 TWA can produce significant improvements in DASH scores and good satisfaction rates. However, a significant number of implants showed radiological loosening, with a high associated complication and revision rate. Patients should be adequately counselled on these risks pre-operatively.
