Long-term outcome of Volz total wrist arthroplasties

The authors determined the outcomes of 18 consecutive Volz total wrist arthroplasties that were followed for an average of 8.6 years. Nine of these wrists were followed for 10 or more years. Fourteen wrists were replaced for rheumatoid arthritis and four for post-traumatic degenerative joint disease. Forty-nine degrees of combined flexion and extension and 25 degrees of combined ulnar and radial deviation were maintained. The balance of wrist motion was dependent upon the design and location of the metacarpal prosthesis. A 24% loss in carpal height (subsidence) occurred during the study period. Four metacarpal components were loose (22%), three of which were placed in patients with degenerative joint disease. One radial component (6%) was loose. Fifteen of 18 wrists (83%) had little or no pain. The three wrists with moderate or severe pain were in patients with degenerative joint disease. There were five (28%) complications. One revision was performed and another was recommended. Overall, the long-term outcome of total wrist arthroplasty was favorable in patients with rheumatoid arthritis.