Complication rates and modes of short and medium-term failure in Motec total wrist arthroplasty: an international cohort study

Redfern, James A. I.; Mehta, Nisarg; Farnebo, Simon; McGuire, Duncan; Solomons, Michael; Thomas Thorvaldson, K.; Estfan, Rami; Brown, Daniel J.

doi:10.1177/17531934231195689

Cited by 5 publications

(1 citation statement)

References 20 publications

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“…In the article by Redfern et al (2023), five international centres have collaborated to present the short-and medium-term results of the Motec TWA.…”

Section: Introductionmentioning

confidence: 99%

Total wrist arthroplasty: commentary and opinions

Smith,

Maling,

Williamson

2023

J Hand Surg Eur Vol

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Total wrist arthroplasty (TWA) is gaining interest as a management option for wrist arthritis. This review article summarizes the current evidence base for TWA, focusing on the performance and survivorship of fourth-generation implants. These appear to offer satisfactory patient-reported outcomes and survivorship over the medium term, but heterogeneity between implants and patient populations complicates data interpretation. We discuss issues facing TWA practice, including surgical competency, volume, implant development and stewardship. We acknowledge the need for further research on this topic and highlight a number of questions that need answering.

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“…In the article by Redfern et al (2023), five international centres have collaborated to present the short-and medium-term results of the Motec TWA.…”

Section: Introductionmentioning

confidence: 99%

Total wrist arthroplasty: commentary and opinions

Smith,

Maling,

Williamson

2023

J Hand Surg Eur Vol

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Investigation of the In Vivo Performance of Metal-on-Metal Motec Total Wrist Arthroplasty – An Explant Analysis

Kandemir,

Julian,

Joyce

et al. 2024

J Wrist Surg

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Background Despite the Motec metal-on-metal (MoM) total wrist arthroplasty (TWA) being among the most implanted and most reported implants, there remains concern about the articulation following the issues in hips, where early wear led to catastrophic failure. Methods Explant analysis was undertaken on seven MoM Motec wrists, explanted for technical issues in the first 3 years postimplantation, at the macro-, micro-, and nanoscales. Results Compared with unworn Motec implants, five of the explanted heads and five of the cups became smoother in vivo. The articulating surfaces of every explanted component had negative skewness. The articulating surfaces of the components did not show any of the major damage associated with hip implants but did demonstrate multidirectional scratches and dark marks mainly situated toward their equator. Four explants showed indentation marks on the rims of their cups and necks from component impingement. The nano- and macroscale observations suggested abrasive wear to be the dominant wear mechanism. Most components demonstrated evidence of self-polishing. Conclusion In the short term, the MoM Motec TWA does not seem to be affected by the wear issues seen in failing MoM total hip replacements with all of the explanted Motec components remaining within manufacturing tolerances

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Long-term results and explant analysis of the ReMotion total wrist arthroplasty

Stringer,

Cash,

Kennedy

et al. 2023

J Hand Surg Eur Vol

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The ReMotion wrist replacement has good short- to medium-term survival with an acceptable complication profile as we previously reported in a cohort of patients with rheumatoid arthritis. We now report the long-term results of the same cohort and details of explant analysis of revisions undertaken for aseptic loosening. A total of 16 wrists were reviewed. Seven prostheses remain in situ with no obvious signs of wear or radiological loosening at a mean follow-up of 15.5 years. Three wrists had been revised: one for infection and two for aseptic loosening. Five patients (six wrists) died 2–9 years after operation from unrelated causes. Explant analysis demonstrated relatively minor wear compared with the published results of the Universal-2 prosthesis. We hypothesize that this may be explained by differences in polyethylene sterilization and prosthetic design. The ReMotion wrist replacement has favourable long-term results in patients with rheumatoid arthritis with a 16-year survival rate of 78%–86%. Level of evidence: IV

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Complication rates and modes of short and medium-term failure in Motec total wrist arthroplasty: an international cohort study

Cited by 5 publications

References 20 publications

Total wrist arthroplasty: commentary and opinions

Total wrist arthroplasty: commentary and opinions

Investigation of the In Vivo Performance of Metal-on-Metal Motec Total Wrist Arthroplasty – An Explant Analysis

Long-term results and explant analysis of the ReMotion total wrist arthroplasty

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