Biaxial total wrist replacement in patients with rheumatoid arthritis

Takwale, V. J.; Nuttall, D.; Trail, IA; Stanley, John

doi:10.1302/0301-620x.84b5.0840692

Cited by 40 publications

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“…There were radiolucent zones in 4 of 17 cases with a mean follow-up time of 6 years, without other signs of implant loosening. Takwale et al (2002) re-examined 76 Biaxial TWAs with a mean follow-up time of 4 years. Implant survival was 0.86 and 14 more cases showed radiographic signs of prosthetic loosening, but it was not reported whether osteolysis was associated with subsidence or angulation of the implant components.…”

Section: Discussionmentioning

confidence: 99%

Favorable results after total wrist arthroplasty

Boeckstyns¹,

Herzberg

Merser³

2013

Acta Orthopaedica

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Background and purpose During the past 40 years, several attempts have been made with total wrist arthroplasty to avoid fusion in severely destroyed wrists. The results have often been disappointing. There is only modest clinical documentation due to the small number of patients (especially non-rheumatoid cases) and short follow-up times. Here we report a multicenter series using a third-generation implant with a minimum follow-up time of 5 years.Methods In 2012, data were retrieved from a registry of consecutive wrist operations at 7 centers with units specialized in hand surgery, between 2003 and 2007. The wrists had been reviewed annually and analysis was done on the latest follow-up data.Results 60 patients had been operated (5 bilaterally), 5 wrists had been revised, and 52 were available for follow-up (with the revised cases excluded). The pain scores, QuickDASH scores, ulnar flexion, and supination for the whole group were statistically significantly better at follow-up. There were no statistically significant differences between the rheumatoid and the non-rheumatoid patients except for motion, which was better in the non-rheumatoid group. The motion obtained depended on the preoperative motion. Implant survival was 0.9 at 5–9 years.Interpretation The clinical results in terms of pain, motion, strength, and function were similar to those in previous reports. The implant survival was 0.9 at 9 years, both in rheumatoid and non-rheumatoid cases, which is an important improvement compared to the earlier generations of total wrist arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Favorable results after total wrist arthroplasty

Boeckstyns¹,

Herzberg

Merser³

2013

Acta Orthopaedica

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“…Survival at 5 years was 83% with revision as an endpoint and 75% of patients had complete relief of pain and function at the wrist [3]. Stanley and Tolat [6], in their series of 50 Swanson wrist implants with an average follow-up period of 8 years (range 6-11.8), found that two-thirds of patients had a good-to-excellent result assessed by a summary score including pain, patient satisfaction function, and wrist motion [1,4].…”

Section: Discussionmentioning

confidence: 99%

“…Various generations of primary total wrist replacement have been devised and many authors have reported their experience [1][2][3][4][5]. Complications of total wrist replacement include loosening, infection, dislocation, tendon rupture, ulnar deviation, and imbalance.…”

Section: Introductionmentioning

confidence: 99%

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Revision of a failed Swanson arthroplasty to a total wrist replacement restores wrist function and movements

Khan¹,

Konan²,

Sorene³

2013

Journal of Plastic Surgery and Hand Surgery

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This study reports a case of revision of a failed Swanson silastic interpositional wrist replacement to a Universal 2 (KMI Medical Inc., San Diego, CA, Jan 2009) total wrist arthroplasty, in a 68-year-old woman with rheumatoid arthritis and pyrophosphate arthropathy. At the 2-year follow-up, the patient was pain-free and was able to perform all activities of daily living, documented by subjective assessment and objective scores. The disabilities of the arm, shoulder, and hand (DASH) scores improved from 98.3 preoperatively to 55.1 postoperatively. A failed Swanson silastic interpositional wrist replacement may be successfully revised to an uncemented primary wrist replacement with good functional results at early follow-up.

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“…Die Operationstechnik war die gleiche wie bei Beckenbaugh. Die distale Komponente wurde jeweils zementiert.Bei einer späteren Nachuntersuchung[16] konnten in der gleichen Klinik von den im Zeitraum 1992 bis 1999 implantierten 76 BIAX-Prothesen bei 73 Rheumapatienten insgesamt 66 Prothesen bei 63 Patienten nach viereinhalb Jahren ( bis 8 Jahre) nachuntersucht werden. Es wurde die distale Komponente bei 79% zementiert und nur in der Anfangszeit die proximale bei 14%.…”

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Die BIAX-Handgelenkprothese als Alternative zur Arthrodese bei degenerativer und posttraumatischer Arthrose - Frühergebnisse bei 21 Patienten

Kretschmer

Wannske²

2003

Handchir Mikrochir plast Chir

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The BIAX total wrist prosthesis was first implanted 1983 by Beckenbaugh in the United States. From a total of twenty-one BIAX-prostheses between March 2001 and February 2002, we have inserted eleven in patients for degenerative arthrosis, eight for posttraumatic arthrosis and two for rheumatoid arthritis of the wrist. The average age of the patients was 53.0 +/- 10.7 years with a follow-up between eleven and fourteen months on an average of one year. The motion of the operated joints was preserved on average. We have taken pain as the main criterion for the success of the operation and distinguished between pain at rest, in motion and under exertion. All patients showed a very good pain relief of 5 1/2 values from 6 1/2 before to one after surgery on a scale from one to ten. Pain relief is less under exertion, thus we are reserved with heavy workers of the implantation of the prosthesis. Apart from that, the indication corresponds to the arthrodesis of the wrist. The satisfaction of patients with the prosthesis is very high: 17 patients declared it was much better, three declared it was better and only one patient said it was unchanged. Complications occurred in six patients. The main complication was the postoperative dislocation of the prosthesis in three patients. After repositioning, the joints were long-term stable. The straight secured surgical technique is described in detail. For the majority of patients with posttraumatic or degenerative arthrosis, as well as with rheumatoid arthritis, the BIAX wrist prosthesis is recommended as a first-time operation as an alternative to wrist arthrodesis due to pain relief with preservation of joint motion and good acceptance among patients.

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Biaxial total wrist replacement in patients with rheumatoid arthritis

Cited by 40 publications

References 0 publications

Favorable results after total wrist arthroplasty

Favorable results after total wrist arthroplasty

Revision of a failed Swanson arthroplasty to a total wrist replacement restores wrist function and movements

Die BIAX-Handgelenkprothese als Alternative zur Arthrodese bei degenerativer und posttraumatischer Arthrose - Frühergebnisse bei 21 Patienten

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