The Role of Wrist Fusion and Wrist Arthroplasty in Rheumatoid Arthritis

Abstract

Rheumatoid arthritis is the most common form of inflammatory arthritis with a predilection for the hand and wrist. The aggressive nature of the disease can lead to severe joint destruction causing significant disability. Surgical options for pan-carpal arthritis include total wrist arthroplasty and total wrist fusion both with varying outcomes, yet both have a role in the carefully selected patients. Fusion remains a popular procedure with consistent reliable results with few complications. We present a review of current evidence, indications and guidance for both fusion and arthroplasty in rheumatoid arthritis.

20 years of rheumatoid hand surgery: what did I learn?

“…Stable wrists with preserved bone stock (Universal Classification types A and B) are the best, if not the only, indication for wrist arthroplasty. Good results can be expected for these patients, even in the long-term (Bhamra et al., 2017; Ogunro et al., 2013). However, the revision of a failed wrist arthroplasty is difficult and technically demanding.…”

Wrist Arthrodesis in Rheumatoid Arthritis by Parallel K Wires and Ulna Autograft: A Case Report

“…Although total wrist arthroplasty may be a more appealing treatment for the severely destroyed rheumatoid wrist, function may not be significantly better than for arthrodesis, and current evidence does not support the widespread implementation of this procedure. [16][17][18] conclusIon…”

Konservative und operative Therapie der rheumatischen Hand

“…Da viele dieser Patienten auf Gehhilfen angewiesen sind, droht zudem eine Überlastung der Prothese. Daneben sind Lockerungen vor allem distal bei osteoporotischem Knochen relativ häufig 30 .…”