Promising one- to six-year results with the Motec wrist arthroplasty in patients with post-traumatic osteoarthritis

Abstract

The Motec cementless modular metal-on-metal ball-and-socket wrist arthroplasty was implanted in 16 wrists with scaphoid nonunion advanced collapse (SNAC; grades 3 or 4) and 14 wrists with scapholunate advanced collapse (SLAC) in 30 patients (20 men) with severe (grades 3 or 4) post-traumatic osteoarthritis of the wrist. The mean age of the patients was 52 years (31 to 71). All prostheses integrated well radiologically. At a mean follow-up of 3.2 years (1.1 to 6.1) no luxation or implant breakage occurred. Two wrists were converted to an arthrodesis for persistent pain. Loosening occurred in one further wrist at five years post-operatively. The remainder demonstrated close bone-implant contact. The clinical results were good, with markedly decreased Disabilities of the Arm Shoulder and Hand (DASH) and pain scores, and increased movement and grip strength. No patient used analgesics and most had returned to work. Good short-term function was achieved using this wrist arthroplasty in a high-demand group of patients with post-traumatic osteoarthritis.

Total wrist arthroplasty: a systematic review of the evidence from the last 5 years

“…The total number of articles generated by searches using Medline and Embase were 85 and 248, respectively. Eight articles met the minimum standard set out in the methodology for inclusion (Boeckstyns et al, 2013;Ferreres et al, 2011;Harlingen et al, 2011;Krukhaug et al, 2011, Morapudi et al, 2012Nydick et al, 2012;Reigstad et al, 2012;Ward et al, 2011). A Cochrane search revealed no currently published reviews.…”

“…This article showed an improvement, and both articles had similar post-operative scores, as shown in Table 4. The pain scores used in different articles were not comparable, but all demonstrated an improvement in pain scores post-operatively (Boeckstyns et al, 2013;Morapudi et al, 2012;Nydick et al, 2012;Reigstad et al, 2012). This is summarized in Table 5.…”

“…Six articles used DASH scores, and five articles recorded pre-operative baseline scores (Boeckstyns et al, 2013;Harlingen et al, 2011;Morapudi et al, 2012;Nydick et al, 2012;Ward et al, 2011). The Motec had the best post-operative DASH scores (Reigstad et al, 2012), while the Universal 2 had the worst postoperative DASH scores (Morapudi et al, 2012). Two articles looking at the Universal 2 prosthesis used PRWE scores (Ferreres et al, 2011;Morapudi et al, 2012), but only one made a comparison of preoperative with post-operative scores (Morapudi et al, 2012).…”

“…Grip strength was examined in three articles (Boeckstyns et al, 2013;Harlingen et al, 2011;Reigstad et al, 2012). Two of these articles compared pre-operative and post-operative scores (Boeckstyns et al, 2013, Reigstad et al, 2012.…”

“…The Universal 2 prosthesis, which had the highest survival rate, displayed no revisions until 2 years post-surgery, then declined at a steady rate (Ward et al, 2011). All the other prosthesis displayed smooth curves, with a steady rate of failure, with no obvious early failure or indication of acceleration with increasing follow-up periods (Boeckstyns et al, 2013;Harlingen et al, 2011;Krukhaug et al, 2011;Reigstad et al, 2012). The report of the Norwegian Arthroplasty register provides survivorship data and reasons for revision, but reasons were not mutually exclusive (Krukhaug et al, 2011).…”