Can Total Wrist Arthroplasty Be an Option in the Treatment of the Severely Destroyed Posttraumatic Wrist?

Abstract

Total wrist arthroplasty (TWA) still remains a controversial procedure. Early types of implants have given disappointing results: The first generation were silicone implants whose risks included implant breakage, subsidence, and silicone synovitis.1-3 The next generation of implants required extensive bone resection, which had implications if Keywords► total wrist arthroplasty ► posttraumatic ► wrist arthritis ► wrist arthrosis ► prospective AbstractBackground Severely destroyed posttraumatic wrists are usually treated by partial or total wrist fusion or proximal row carpectomy. The indications for and longevity of total wrist arthroplasty (TWA) are still unclear. Case Description The aim of this study was to analyze a series in which one lastgeneration total wrist arthroplasty was used as a salvage procedure for wrists with severe arthritis due to traumatic causes. The data were prospectively recorded in a webbased registry. Seven centers participated. Thirty-five cases had a minimum follow-up time of 2 years. Average follow-up was 39 (24-96) months. Pain had improved significantly at follow-up, mobility remained unchanged. The total revision rate was 3.7%, and the implant survival was 92% at 4-8 years.Literature Review Very few studies have described specific results after TWA in posttraumatic cases and almost none using classical "third-generation" implants. The number of cases and the follow-up in the published series are small. Clinical Relevance Although painful posttraumatic wrists with severe joint destruction can be salvaged by partial or total fusion, we found that, evaluated at short-to midterm, total wrist arthroplasty can be an alternative procedure and gives results that are comparable to those obtained in rheumatoid cases. Level IV Case series

Does Total Wrist Arthroplasty for Treatment of Posttraumatic Wrist Joint Osteoarthritis in Young Patients Always Lead to Restriction of High-demand Activities of Daily Living? Case Report and Brief Review of Recent Literature

“…Recently, rheumatoid arthritis remains the most common indication for TWA with relative portion ranging from 51-71% of all patients receiving TWA [ 18 , 19 ]. However, TWA has proven to be useful as a motion-preserving alternative to TWF for treatment of posttraumatic wrist joint OA as well, and also resulted in a significantly better outcome than in patients who underwent a primary TWF [ 20 , 21 ]. TWA for treatment of posttraumatic wrist joint OA (including scaphoid non-union/scapholunate advanced collapse) has reported to be a relative portion of 14% of all TWAs performed by surgeons who have published their experiences with this procedure [ 18 ].…”

A systematic review and network meta-analysis of outcomes after total wrist arthroplasty in inflammatory and non-inflammatory arthritis

“…The search yielded 1858 results. After screening and full-text review, 12 studies met the inclusion criteria (Figure 1) (Badge et al, 2016;Boeckstyns et al, 2013;Brinkhorst et al, 2018;Ferreres et al, 2011;Harlingen et al, 2011;Holm-Glad et al, 2022;Holzbauer et al, 2022;Honecker et al, 2019;Matsui et al, 2020;Reigstad et al, 2012Reigstad et al, , 2017Rossello et al, 2022). Reigstad et al (2012Reigstad et al ( , 2017 presented their initial results in 2012, followed by a follow-up report in 2017; only data from the 2017 analysis were included in our analysis.…”

“…The search yielded 1858 results. After screening and full-text review, 12 studies met the inclusion criteria (Figure 1) (Badge et al., 2016; Boeckstyns et al., 2013; Brinkhorst et al., 2018; Ferreres et al., 2011; Harlingen et al., 2011; Holm-Glad et al., 2022; Holzbauer et al., 2022; Honecker et al., 2019; Matsui et al., 2020; Reigstad et al., 2012, 2017; Rossello et al., 2022). Reigstad et al.…”

“…In total, 10 studies reported DASH or Quick-DASH scores (Badge et al., 2016; Boeckstyns et al., 2013; Brinkhorst et al., 2018; Harlingen et al., 2011; Holm-Glad et al., 2022; Holzbauer et al., 2022; Honecker et al., 2019; Matsui et al., 2020; Reigstad et al., 2012, 2017). TWA was found to significantly improve DASH or Quick-DASH scores for both indications compared to preoperative baselines.…”

“…Six studies reported pain outcomes using the VAS scale (Badge et al., 2016; Boeckstyns et al., 2013; Brinkhorst et al., 2018; Holzbauer et al., 2022; Honecker et al., 2019; Rossello et al., 2022). TWA resulted in a statistically significant improvement in pain VAS scores compared to preoperative baseline in both indications.…”