Early results of the Universal total wrist arthroplasty in rheumatoid arthritis

Divelbiss, Brian J.; Sollerman, Christer; Adams, Brian D.

doi:10.1053/jhsu.2002.31728

Cited by 122 publications

(76 citation statements)

References 31 publications

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“…17 In a study of 31 patients treated with the Universal prosthesis and followed up for a mean of 6.7 years, 17 88% were painfree, and the mean arc of flexion-extension increased from 56º to 78º, but the overall complication rate was 32%, with 5 patients developing volar dislocation. In another study of 22 cases, 18 the range of motion and patient satisfaction increased significantly, but the rate of dislocation remained high at 14%.…”

Section: Vol 20 No 3 December 2012mentioning

confidence: 91%

Total Wrist Arthroplasty Using the Universal 2 Prosthesis

Morapudi

Marlow

Withers

et al. 2012

J Orthop Surg (Hong Kong)

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purpose. To report outcomes of 21 total wrist arthroplasties (TWA) using the Universal 2 prosthesis. Methods. Five men and 14 women aged 44 to 82 (mean, 62) years underwent 21 total wrist arthroplasties for rheumatoid arthritis (n=19) and post-traumatic arthritis (n=2) by a single surgeon using the Universal 2 prosthesis. Pre-and post-operative pain and function were assessed by a single surgeon using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the patient-rated wrist evaluation (PRWE) score. Range of motion, stability, dislocation rate, and neurovascular status were also assessed. Radiographs were evaluated for implant alignment and fit, screw positioning, and implant loosening. results. The mean time to assessment of the range of motion was 3.1 (range, 1.8-3.9) years, and the mean time to assessment of the PRWE score was 4.8 (range, 2.1-7.3) years. The range of motion in each direction and the mean DASH and PRWE scores improved significantly following TWA. Two patients Total wrist arthroplasty using the Universal 2 prosthesis 2012;20(3):365-8 had restricted range of motion, which was treated by manipulation under anaesthetic (after 6 months in one and 8 weeks in the other). One patient underwent excision of a palmar bony bridge. One patient endured extensor pollicis longus rupture and underwent tendon transfer after 5 months. Radiographs revealed no evidence of implant loosening, migration, or malalignment. There was no sign of osteonecrosis in the remaining carpals or metacarpals. conclusion. The Universal 2 TWA achieved significant improvement in range of motion and functional outcome of the wrist, with reduced rates of early joint instability, dislocation, and implant loosening, compared to previous implants. The small implant size and cementless design reduce bone loss and osteonecrosis. Journal of Orthopaedic Surgery

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Section: Vol 20 No 3 December 2012mentioning

confidence: 91%

Total Wrist Arthroplasty Using the Universal 2 Prosthesis

Morapudi

Marlow

Withers

et al. 2012

J Orthop Surg (Hong Kong)

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“…Instability and implant loosening are the most common TWA complications but are often preventable. Newer technologies that rely on the distal component fixed to the carpus with concomitant intercarpal fusion have significantly reduced the incidence of loosening compared to older models fixed into the metacarpal shafts (98,99).…”

Section: Complications and Management: Arthroplastymentioning

confidence: 99%

“…In the setting of a painful wrist with pancarpal arthritis, it can be difficult to elucidate any symptomatic DRUJ pathology from other causes of pain due to arthritis. In such cases, it may be most judicious to leave the DRUJ intact at the time of arthroplasty, while informing the patient that additional surgery may be indicated in the future to address the DRUJ (99). This can be particularly wise in those patients with OA with ulnar neutral/negative variance, so as not to further exacerbate the variance with removal of a portion of distal ulna (3,4).…”

Section: Complications and Management: Arthroplastymentioning

confidence: 99%

Management of Complications of Wrist Arthroplasty and Wrist Fusion

2015

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“…Newer devices are better than their predecessors but continue to have high revision and failure rates compared to other large joint arthroplasties [9].…”

mentioning

confidence: 99%

Reconstructing the Rheumatoid Wrist: A Utility Analysis Comparing Total Wrist Fusion and Total Wrist Arthroplasty from the Perspectives of Rheumatologists and Hand Surgeons

Cavaliere

Oppenheimer

Chung

2009

Hand (New York, N,Y.)

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Rheumatologists and hand surgeons have historically demonstrated strikingly divergent attitudes toward the benefits of surgical intervention, either total wrist fusion or total wrist arthroplasty, for the rheumatoid wrist. A utility analysis was conducted to compare a national random sample of hand surgeons and rheumatologists regarding their opinions about surgical management of severe rheumatoid wrist disease. A web-based trade-off utility survey was developed, and participants were presented with survey scenarios comparing well-controlled rheumatoid arthritis with operative and non-operative management. Utility values were calculated for each scenario, and a decision analytic model was constructed. Utility values for rheumatologists and hand surgeons did not differ significantly for any scenario. Total wrist arthroplasty was associated with the highest expected gain in quality-adjusted life-years for each subgroup. This decision analytic model demonstrates similar opinions between two subspecialties that have historically demonstrated divergent attitudes towards rheumatoid hand surgery.

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Early results of the Universal total wrist arthroplasty in rheumatoid arthritis

Cited by 122 publications

References 31 publications

Total Wrist Arthroplasty Using the Universal 2 Prosthesis

Total Wrist Arthroplasty Using the Universal 2 Prosthesis

Management of Complications of Wrist Arthroplasty and Wrist Fusion

Reconstructing the Rheumatoid Wrist: A Utility Analysis Comparing Total Wrist Fusion and Total Wrist Arthroplasty from the Perspectives of Rheumatologists and Hand Surgeons

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