Salvage Universal 2 total wrist replacement for a failed Swanson prosthesis

Khan, Y.; Sorene, Elliot

doi:10.1016/j.injury.2010.04.004

Cited by 1 publication

(1 citation statement)

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“…It is difficult to compare the 82% 5-year survival rate with previous studies as published data are limited to two case reports. 18,19 The previous reporting of clinical outcomes is variable. Two studies identified that the Biaxial implant achieves 19 degrees of mean flexion and 31 and 36 degrees of mean extension when used as a revision prosthesis.…”

Section: Discussionmentioning

confidence: 99%

Survivorship of Revision Wrist Replacement

et al. 2017

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This study aims to report the 5-year survivorship of revision wrist arthroplasties and to report midterm clinical and radiological results. All patients receiving a revision wrist arthroplasty in our unit between January 1, 1997 and October 31, 2010 were identified, and clinical notes retrospectively analyzed for Quick Disabilities of the Arm, Shoulder and Hand (quickDASH), Patient Evaluation Method (PEM), Patient-Rated Wrist Evaluation (PRWE), the range of movement, and visual analog score (VAS). In cases where patient review had not occurred within the past year, they were invited for assessment, and this data was included in the analysis. Plain radiographs were analyzed for loosening of each component. The 5-year survival was plotted using Kaplan-Meier analysis. Of the 19 patients identified, 1 was lost to follow-up and therefore excluded from all analyses. Mean age at revision wrist arthroplasty was 55.8 years and the mean time from primary to revision wrist arthroplasty was 6.7 years. At revision arthroplasty, 7 patients received the Biaxial implant (DePuy, Inc., Warsaw, IN) and 11 received the Universal II implant (Integra, Inc., Plainsboro, NJ). The 5-year implant revision survivorship was 83%. Depending on the variable of interest, clinical data were available for either three, four or five patients. At final follow-up (mean: 10.4 years), mean visual analog score was 2.9, mean quickDASH 57, mean PEM 49, mean PRWE 61, and mean arc of flexion/extension was 26 degrees. Radiological data were available for 12 patients, with evidence of gross loosening present in around 60% of the carpal components and 50% of the radial components at mean 6.7 years. Revision wrist replacement implant survival is acceptable, but the majority of the surviving implants are radiologically loose. It is not clear at this time whether they are better or worse than a fusion after a failed primary wrist arthroplasty. It is reasonable to offer revision wrist arthroplasty in selective cases, but regular clinical and radiological follow-up is recommended.

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Section: Discussionmentioning

confidence: 99%