Total Wrist Arthroplasty

Weiss, Arnold‐Peter C.; Kamal, Robin N.; Shultz, Paul

doi:10.5435/jaaos-21-03-140

Cited by 24 publications

(26 citation statements)

References 32 publications

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“…Likewise, with the advent of new implant technology, TWA is increasingly offered as a treatment option to patients with posttraumatic arthritis and OA if they are able to maintain certain activity restrictions. 26 Currently, fourth-generation implants are available in the market. Fourth-generation designs have been proposed in an attempt to solve the complications with previous models, mainly loosening of the distal component.…”

Section: Discussionmentioning

confidence: 99%

Trends in the Utilization of Total Wrist Arthroplasty versus Wrist Fusion for Treatment of Advanced Wrist Arthritis

et al. 2016

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Background Total wrist arthroplasty (TWA) provides the requisite range of motion to accomplish activities of daily living, especially for low-demand patients with bilateral wrist arthritis. However, there are no large epidemiologic studies to evaluate nationwide trends of TWA and wrist fusion (WF). Questions/Purposes To analyze data collected from the National Inpatient Sample (NIS) to compare utilization, demographic, and outcome data among patients undergoing TWA versus total WF. We hypothesized that utilization rates of TWA have significantly increased over the prior decade in the United States. Methods NIS data from 2001 to 2010 were reviewed. Procedures were identified by ICD-9-CM codes 81.73 (TWA) and 81.25 (WF). Utilization rates, primary treatment diagnoses, patient demographic and medical comorbidity data, and procedure costs were compared between TWA and WF. Results There was a decrease in the number of procedures per year for TWA, while the number of WF remained relatively unchanged. There was, however, a transient increase in the frequency of TWA procedures performed from 2005 to 2008, following a decline in 2005. Patients with traumatic arthritis were more likely to receive WF. Rheumatoid patients were more likely to receive TWA. Patients receiving TWA tended to be older, female, be insured by Medicare, have a greater comorbidity burden, and have rheumatologic disease. Conclusion WF was performed nearly four times more frequently than TWA. A trend was demonstrated toward a decreasing number of TWA being implanted, and in patients with more underlying comorbidities. TWA was associated with a higher hospitalization charge, which may be expected given the higher implant costs associated with arthroplasty. Level of Evidence Level II, prognostic study.

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Section: Discussionmentioning

confidence: 99%

Trends in the Utilization of Total Wrist Arthroplasty versus Wrist Fusion for Treatment of Advanced Wrist Arthritis

et al. 2016

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“…1 , 15 The revision rate demonstrated a number of 26% and component loosing cited as the most common complication. 16 , 17 , 18 …”

Section: Wrist Prosthesismentioning

confidence: 99%

The instability of wrist joint and total wrist replacement

2016

Chinese Journal of Traumatology

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Total wrist arthroplasty are not used as widely as total knee and hip replacement. The functional hands are requiring surgeons to design a durable and functional satisfying prosthesis. This article will list the main reasons that cause the failure of the prosthesis. Some remarkable and representative prostheses are listed to show the devolvement of total wrist prosthesis and their individual special innovations to fix the problems. And the second part we will discuss the part that biomechanical elements act in the total wrist replacement (TWA). Summarize and find out what the real problem is and how we can find a way to fix it.

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“…Total wrist arthroplasty (TWA) is a successful 1 and cost effective 2 treatment for end stage wrist arthritis which has demonstrated improved design with each successive generation of implant. 3 Arthroplasty is specifically indicated for inflammatory arthritis, posttraumatic arthritis, and osteoarthritis. 2,[4][5][6] Traditionally these conditions were treated with arthrodesis, 7 however, arthroplasty both alleviates a painful deformity while retaining motion through the radiocarpal joint.…”

mentioning

confidence: 99%

“…Initial TWA designs were plagued by complications, low survivorship, and consisted of a single silicone elastomer. 3,8,9 However, the latest fourth generation designs have made significant advancements and include articulating radial and carpal components of polyethylene and porous-coated metals. Fourth generation designs have demonstrated improved pain, 10,11 range of motion, 10 function, 6 and improved survivorship; 95% at 8 years 11 and 77% at 15 years.…”

mentioning

confidence: 99%

Acute Complications in Total Wrist Arthroplasty: A National Surgical Quality Improvement Program Review

et al. 2019

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Background The study sought to assess the patient-based variables, surgical risk factors, and postoperative conditions associated with readmission after total wrist arthroplasty (TWA). Materials and Methods All patients undergoing TWA were identified from the National Surgical Quality Improvement Program dataset from 2005 to 2016. Patient demographics, medical comorbidities, surgical characteristics, and outcomes were examined to isolate predictors for readmission within 30 days postoperatively. Results A total of 57 patients were identified to have undergone TWA. The average patients were 62.3 (13.8) years old, female (57.7%), and most were treated in the outpatient setting (67.3%). Comorbid conditions included smoking (17.3%), diabetes (15.4%), and chronic steroid therapy (15.4%). No complications were identified in the 30-day postoperative period. There was a trend for increasing utilization of TWA over the years included. Conclusion TWA is a safe procedure with low complication rates in the acute postoperative period. Increasing utilization is likely a result of improved outcomes and cost-effectiveness of TWA. Level of Evidence This is a Level II, prognostic study.

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Total Wrist Arthroplasty

Cited by 24 publications

References 32 publications

Trends in the Utilization of Total Wrist Arthroplasty versus Wrist Fusion for Treatment of Advanced Wrist Arthritis

Trends in the Utilization of Total Wrist Arthroplasty versus Wrist Fusion for Treatment of Advanced Wrist Arthritis

The instability of wrist joint and total wrist replacement

Acute Complications in Total Wrist Arthroplasty: A National Surgical Quality Improvement Program Review

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