Current Indications and Outcomes of Total Wrist Arthroplasty

Ogunro, Shade; Ahmed, Irfan; Tan, Virak

doi:10.1016/j.ocl.2013.03.008

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…In addition, surgical techniques within studies were also often inconsistent. An important part of the surgical technique in all the implants used is to achieve intercarpal fusion to provide a stable foundation for the carpal component and reduce loosening and subsidence (Menon, 1998; Ogunro et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Total wrist arthroplasty: a systematic review of the evidence from the last 5 years

Yeoh¹,

Tourret²

2014

J Hand Surg Eur Vol

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We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3-7.3 years with an average age of 52-63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3-5 years), while Elos had the lowest (57% at 5 years). Biaxial had the highest complication rates (68.7%), while Remotion had the lowest (11%). Wrist arthroplasty preserves some range of motion. Functional scores improved and were maintained over the mid- to long-term. Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. The evidence does not support the widespread use of arthroplasty over arthrodesis, and careful patient selection is essential.

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Section: Discussionmentioning

confidence: 99%

Total wrist arthroplasty: a systematic review of the evidence from the last 5 years

Yeoh¹,

Tourret²

2014

J Hand Surg Eur Vol

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“…It has to compete with established procedures, such as arthrodesis [1]. In addition to the pain situation, the preservation of mobility, particularly of the fingers, and improvement of strength, as well as participation in daily life, are of central importance, especially since the demands of rheumatic patients are increasing due to an improvement of new medical therapies [2]. The results of our cohort reflect a high level of patient satisfaction.…”

Section: Discussionmentioning

confidence: 71%

“…If surgical treatment is necessary, the preservation of residual mobility must be included in the planning, since arthrodesis of the wrist significantly limits its function [1]. Preoperatively, the situation of the bone and the reconstructability of the carpal height, soft-tissue balance, kinematics, and joint pivot point must be carefully examined in advance [2,3]. Recent developments in wrist endoprosthesis offer movement-preserving treatment and at the same time improve the rate of complications [4].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW®) in Patients with Inflammatory Diseases

Biehl

Stoll²,

Heinrich

et al. 2021

Life

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The wrist is among the predilection sites of over 90% of cases of rheumatoid arthritis (RA). In advanced cases, total wrist arthroplasty (TWA) is an alternative to arthrodesis. The aim of this study is to present the long-term results of the modular physiological wrist prosthesis (MPW®) and to match them in context with the results of a standard population survey. In a retrospective study with follow-up, patients with an MPW® endoprosthesis were evaluated concerning the clinical and radiological outcome, complications were reviewed (incidence and type), and conversion to wrist fusion was assessed. Patient function measurements included the Mayo wrist score, the patient-specific wrist test, and therefore the DASH score (arm, shoulder, and hand). Thirty-four MPW® wrist prostheses were implanted in 32 patients, including thirty primary implantations and four changes of the type of the endoprosthesis. Sixteen patients (18 prostheses) underwent clinical and radiological follow-up. The average follow-up time was 8.5 years (1 to 16). Poor results of the MPW prosthesis are caused by the issues of balancing with luxation and increased PE wear. Salvage procedures included revision of the TWA or fusion. In successful cases, the flexion and extension movement averaged 40 degrees. The grip force was around 2.5 kg. The common DASH score was 79 points, with limited and problematic joints of the upper extremity. The MPW wrist prosthesis offered good pain relief and functional movement in over 80% of cases. The issues of dislocation and increased PE wear prevent better long-term results, as do the joints affected. A follow-up study with fittings under a contemporary anti-rheumatic therapy with biologicals suggests increasing score results. Type of study/level of evidence: Case series, IV.

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“…The ReMotion total wrist was introduced in 2002, and first short-to medium term results were encouraging [25,[32][33][34][35]. Depending on the definition for failed TWA (required implant removal vs. loosening of carpal component without required implant removal) and the varying number of patients were evaluated in uni-or multicentric studies, midto long-term survivorship for the ReMotion is reported to be 69 to 100% [29,[36][37][38][39][40].…”

Section: Discussionmentioning

confidence: 99%

"Off label" use of the ReMotionTM total wrist for treatment of advanced stage of post-traumatic pancarpal wrist osteoarthritis: Report of two cases and review of literature

Schmidt¹,

Beylich²

2020

Trauma Emerg Care

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The ReMotion total wrist is one 3rd generation implant which is current in use. Mid-to long-term outcomes regarding its survivorship revealed satisfying results. However, this implant has a design-related issue resulting in development of painful radial-side impingement. We present two cases involving two modified implantation techniques ((1) complete removal of scaphoid accompanied by partial cement augmentation of the radial-side fixation screw for carpal component, and (2) positioning of both fixation screws for carpal component into the scaphoid adjacent to the capitate peg without crossing the carpometacarpal joins) which could be able to avoid this specific complication. However, such an "off label" use in the absence of a larger number of patients and further biomechanical investigations can only be used in single cases currently.

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Current Indications and Outcomes of Total Wrist Arthroplasty

Cited by 10 publications

References 17 publications

Total wrist arthroplasty: a systematic review of the evidence from the last 5 years

Total wrist arthroplasty: a systematic review of the evidence from the last 5 years

Long-Term Results of the Modular Physiological Wrist Prosthesis (MPW®) in Patients with Inflammatory Diseases

"Off label" use of the ReMotionTM total wrist for treatment of advanced stage of post-traumatic pancarpal wrist osteoarthritis: Report of two cases and review of literature

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