[Distal Radioulnar Joint Arthroplasty: Historical Milestones and Current Implant Concepts]

Although distal radioulnar joint (DRUJ) arthroplasty is supported by more than five decades of clinical experience and modern implants have demonstrated reliable short- and long-term outcomes both in the management of DRUJ arthritis and in the restoration of stability in cases of painful instability following ulnar resection procedures, its clinical adoption remains limited compared with other types of joint replacement. This narrative review summarizes the historical development and biomechanical principles of DRUJ arthroplasty and compares current endoprosthetic concepts - ranging from partial surface replacements and ulnar head prostheses to semi-constrained and non-constrained total joint replacements - with respect to their advantages, limitations, and reported clinical outcomes. Finally, a practical decision-making algorithm is proposed to assist in selecting the most appropriate implant for patients with DRUJ arthritis or painful ulnar impingement.