Total Wrist Arthroplasty With a New Design, 20 Cases With 8-Year Follow-Up

Daniel Reiser; Per Fischer; Kurt Pettersson; Per Wretenberg; Marcus Sagerfors

doi:10.1016/j.jhsa.2023.08.004

Total Wrist Arthroplasty With a New Design, 20 Cases With 8-Year Follow-Up

J Hand Surg Am. 2023 Sep 15:S0363-5023(23)00446-X. doi: 10.1016/j.jhsa.2023.08.004. Online ahead of print.

Authors

Daniel Reiser¹, Per Fischer¹, Kurt Pettersson¹, Per Wretenberg¹, Marcus Sagerfors²

Affiliations

¹ Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
² Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. Electronic address: marcus.sagerfors@regionorebrolan.se.

PMID: 37715756
DOI: 10.1016/j.jhsa.2023.08.004

Abstract

Purpose: Total wrist arthroplasty (TWA) is an established motion-preserving alternative to arthrodesis in the treatment of wrist arthritis, but post-TWA complications requiring additional surgery remain an issue. A new TWA design has been proposed. The purpose of this study was to report the outcome of a cohort study of 20 patients who underwent surgery using the new TWA design.

Methods: Patients were assessed before surgery and at 1, 2, and 8 years after surgery for visual analog scale (VAS) pain scores, wrist range of motion, hand grip strength, and patient-reported outcome measures (PROMs). Radiographic examination was conducted for evidence of prosthetic loosening. Reasons for revision were analyzed.

Results: In total, 24 reoperations were performed, including 12 revisions in 6 patients. Patient-reported outcome measures improved significantly at the 2-year follow-up compared with preoperative values. Hand grip strength, wrist extension, and VAS pain scores improved significantly at the 2-year follow-up. No radiographic loosening of the components was observed, but backing out of the carpal screws was noted in 16 of the 20 cases.

Conclusions: The new TWA resulted in improved VAS pain scores, PROMs, wrist extension, and hand grip strength. The high frequency of reoperation is a concern, and modification of the implant is needed.

Type of study/level of evidence: Therapeutic IV.

Keywords: Total wrist arthroplasty; arthritis; osteoarthritis.