Total Wrist Arthroplasty: New Perspectives

The use of total wrist arthroplasty to treat end-stage arthritic wrists remains controversial because of a high rate of complications. The advent of new designs and smaller prostheses decreases complications and attitudes are gradually changing. The early results of a prospective study of one last generation total wrist arthroplasty in a series of 20 wrists with end-stage arthritic wrists (13 rheumatoid) in 19 patients are presented. There were no intra-operative complications nor reoperations or dislocations. The patients' pain scores improved from 7 preoperatively to 2 postoperatively. Wrist function improved and postoperative motion was very close to wrist functional motion. In the short term follow-up, the new generation total wrist arthroplasty seemed to provide better outcomes when compared with the old generation total wrist arthroplasty. Arthroplasty may be a viable option for the end-stage rheumatoid and osteoarthritic wrist. Longer follow- up is needed to evaluate the durability of the arthroplasty.