Experience of total wrist arthroplasty with silastic implants plus grommets

The experience with radiocarpal joint reconstruction in rheumatoid arthritis using silastic implants and titanium grommets is reported. Forty-one implants were placed in 36 patients from 1986 to 1992, with a followup of 32 implants in 29 patients ranging from 2.5 years to 8 years. After a brief review of the crucial points of the procedure, including indications and surgical technique, the results were examined using a protocol derived from the one proposed in 1988 for an international multicenter study. The procedure, when correct indications are selected and correct surgical steps are performed, allows predictable results with a satisfying recovery of wrist function. Preservation of wrist function through the years seems enhanced by titanium grommets.