Objective. Arthritis of the wrist joint can cause significant pain and decreased motion, resulting in a significant impact on quality of life. Total wrist Arthroplasty can provide pain relief and motion in these patients. Ceramic implants can be used in arthroplasty, but their longer-term performance in the wrist remains unknown. The purpose of the study was to review outcomes utilizing a ceramic total wrist arthroplasty.Material and Methods. А consistent ceramic arthroplasty technique and postoperative regimen was performed. The number of observations subjected to preoperative analysis at Novosibirsk Research Institute for Traumatology and Orthopedics is 63. The results of the study and the nature of the changes determine the indications for wrist arthroplasty. The average observation period was 8 years. Medium-term results were evaluated in 35 patients operated on between 2010 and 2017. The article evaluated three main time points: before the operational intervention, 2017 and 2019. Comparable results of objective and subjective evaluation of the intervention are indicated. X-ray methods and questionnaires were used to analyze the material: the Visual Analogue Pain Syndrome Scale (VAS), the Mayo Clinic Wrist Function Scale (MWS), and the Disability of the Arm, Shoulder and Hand (DASH). All patients underwent total wrist arthroplasty with ceramic endoprosthesis. In one patient, total arthroplasty of both wrists were performed, which corresponds to two clinical cases, in all other cases surgical treatment was carried out on one wrist joint.Results. At the preoperative stage, according to the DASH scale, the result was from 15.8 to 86.2 points, the median was 69.2 (56.2; 76.5) points. Performance characteristics and subjective sensations in the joint according to the MWS questionnaire ranged from 0 to 70, median 30 (15; 45) points. The assessment of the initial state of patients according to the Mayo clinic scale corresponded to very poor results of adaptation and functional activity. The value of the pain scale had indicators from 0 to 10 points, the median was 7 (5; 8) points.In 2017 (second time point), the mean VAS pain score decreased by 2.35 times (by 3.9 points, p < 0.0001), the mean DASH score decreased by 2.64 times (by 40.9 points, p < 0.0001), the average score of the MWS questionnaire increased 1.84 times (by 25.4 points, p < 0.0001). In 2019 (third time point), the average pain syndrome score on the VAS scale decreased by 2.19 times (by 3.7 points, p < 0.0001) compared to the first point; the average score on the DASH scale decreased by 2.25 times (by 36.6 points, p < 0.0001) compared to the first point; the mean score of the MWS questionnaire increased by 1.99 times (by 29.8 points, p < 0.0001) compared to the first point.Conclusions. 1. In the vast majority of cases, there is an increase in the volume of movements in the wrist joint compared to the original condition. 2. According to the results of a midterm study, stability and positive dynamics are noted. 3. Pain syndrome decreases or disappears completely. 4. Preservation of physiological mobility of bones of distal row of wrist contributes to redistribution of force action (damping) and stabilization of components in long period of time. 5. We divide the postoperative period for orthopedic pathology into the nearest (in the hospital), early (up to 2 years), medium-term (2-8 years) and long-term (more than 8 years).

Introduction. Reviews dedicated to surgical treatment of the first carpo-metacarpal joint repeatedly state that the evaluation of arthroplasty results is difficult. This is due to the small clinical study groups and the lack of description of all types of outcomes. The aim of the study is to analyze obtained early and midterm results of ceramic CMC-arthroplasty. The endoprosthesis are represented with unbound proximal and distal components made of ceramic material. The interaction of the head and cup is represented with no intersecting forces that impede on the multi-axial movement. The surgical technique of CMC-1 joint arthroplasty prescribes the installation of components by the press-fit fixation. There is a brief emphasis on the features of the joint and contributing factors for the development of risarthrosis. Early results are described. Cases of unsatisfactory outcomes are described separately. Materials and methods. The study group included patients from 33 to 72 years. The total number of observers was 28 people. We performed revision endoprosthetics in 2 cases (7%), which were associated with aseptic instability of the proximal component according to the osteoporosis. It obvious that endoprosthetics is the only method of orthopedic care that allows maintain mobility and achieve stability of the destroyed CMC joint. Evaluation of the results was carried out by clinical and instrumental methods. Results. It cannot be denied that the CMC arthroplasty is the only method of orthopedic care that allows to preserve mobility and achieve stability of the broken joint. Conclusion. Arthroplasty of the carpo-metacarpal joint with ceramic implants is a promising method of orthopedic care, that allows to restore the function of the hand.

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