Promising Clinical Results of the Universal Total Wrist Prosthesis in Rheumatoid Arthritis

Abstract

Abstract:The purpose of this study was to evaluate the results of the Universal Total Wrist prosthesis.Seventeen wrist arthroplasties were performed in 15 patients using the Universal Total Wrist prosthesis. The 11 women and 4 men in the study group ranged in age from 45 to 86 years. Fourteen patients had rheumatoid arthritis and one had osteoarthritis. Follow up ranged from 20 to 74 months. Patients were evaluated for range of motion, with the Disabilities of the Arm, Shoulder, and Hand (DASH) survey and radiographically.All range of motion values improved after surgery. Average postoperative motion was 29° dorsiflexion, 38° volar flexion, 7° radial deviation and 17° ulnar deviation. The DASH scores improved with 29 %. Pain score improved in all 15 patients. One prosthesis had to be removed due to component loosening of the carpal plate. The other cases showed no radiographic signs of loosening. One patient had an early prosthetic dislocation and was treated conservatively with success.The Universal Total Wrist prosthesis provides a promising outcome in patients with rheumatoid arthritis.

Amandys® implant: Novel pyrocarbon arthroplasty for the wrist

“…Total arthroplasty using a prosthesis gives superior functional results; their use is limited by the high rate of complications and failure [10][11][12][13][14][15][16][17]. New models of the prosthesis have recently been developed but still lack followup [18,19].…”

Review Article: Total Wrist Arthroplasty

“…In addition to the meta-analysis for second-and third-generation implants, 7 this review added 8 new studies of fourth-generation implants, 6,8,9,12,13,16,22,23 3 new studies of third-generation implants, 14,15,17 and one long-term registry study. 18 TWA tends to fail earlier than hip or knee arthroplasties, but TWA has better short-term outcome.…”

“…14 of the studies reported pain relief, 6,[8][9][10][11][12][13]15,17,[19][20][21][22][23] but only 8 used validated scales, and the rest used ordinal scales, severity, and/or frequency to measure pain. Using the visual analogue scale (VAS) for pain, 2 studies reported improvement in the mean score from 8 to 2 (p<0.05) 9 and from 67 to 27 (p<0.001), 23 but one study reported no significant improvement.…”

“…extension, flexion, ulnar deviation, radial deviation, pronation, and supination) and grip strength, based on several wrist scoring systems. 6,[8][9][10][11][12][13][14][15][16][17][19][20][21][22][23] Eight studies used the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire or its shortened version. 9,12,[14][15][16][17]22,23 The DASH questionnaire consists of 30 items related to activities of daily living and symptoms.…”

A Literature Review Comparing the Results of Wrist Arthroplasty and Wrist Fusion in Rheumatoid Patients

“…Winterswijk [12] demonstrated promising clinical results of this prosthesis in rheumatoid arthritis. All range of motion values improved after surgery with the average post-operative motion noted to be 29º of dorsiflexion, 38º volar flexion, 7º radial deviation and 17º ulnar deviation.…”