Wrist Joint Arthroplasty in Rheumatoid Arthritis: A Comparison between the Meuli and Swanson Prostheses

Abstract

A personal series of twelve wrist arthroplasties performed on ten patients with rheumatoid arthritis of the radio-carpal joint were reviewed in retrospect. Six arthroplasties were of the Meuli metal/plastic/metal design and six were of the Swanson silastic type with an additional silastic ulnar head prosthesis. Both prostheses were successful in giving a pain free stable joint with some degree of useful movement. The Meuli appeared to give a greater range of movement than the more constrained Swanson prosthesis. Although complications were encountered it is concluded that wrist arthroplasty does have a place in the management of patients with rheumatoid arthritis of the radio-carpal joint. Our present policy is to continue with the use of the Swanson design because of the advantages of a cement free prosthesis.

A systematic review of outcomes of wrist arthrodesis and wrist arthroplasty in patients with rheumatoid arthritis

“…(2005), who reported 42% of 115 patients were satisfied with their operation (Online Table S5). In patients receiving arthroplasty (319 patients in nine studies), 84% of patients were satisfied with outcome (Cobb and Beckenbaugh, 1996; Ferreres et al., 2011; Figgie et al., 1990; Harlingen et al., 2011; Herzberg et al., 2012; Kistler et al., 2005; Lirette and Kinnard, 1995; Radmer et al., 1999; Summers and Hubbard, 1984).…”

“…Of the six studies examining patients who underwent arthrodesis, one was prospective (Masada et al., 2003) while the remainder were retrospective (Onuma et al., 2015; Rauhaniemi et al., 2005; Rehak et al., 2000; Toma et al., 2007; Vahvanen and Tallroth, 1984). Of the 15 studies evaluating arthroplasty patients, seven studies were prospective (Cobb and Beckenbaugh, 1996; Divelbiss et al., 2002; Ferreres et al., 2011; Figgie et al., 1988; Harlingen et al., 2011; Herzberg et al., 2012; Ward et al., 2011), and eight studies were retrospective (Kistler et al., 2005; Lirette and Kinnard, 1995; Figgie et al., 1990; Pfanner et al., 2017; Radmer et al., 2003, 1999; Summers and Hubbard, 1984; Takwale et al., 2002). Two studies compared arthrodesis versus arthroplasty (Murphy et al., 2003; Vicar and Burton, 1986).…”

“…Other complications in this group included tendon adhesions (12%), extensor tendon irritation (7%), wound dehiscence (5%) and infections (3%). The overall incidence of complications in arthroplasty was 19% (111 cases of 600 indexed operations) from 16 studies (Cobb and Beckenbaugh, 1996;Divelbiss et al, 2002;Ferreres et al, 2011;Figgie et al, 1988Figgie et al, , 1990Harlingen et al, 2011;Herzberg et al, 2012;Lirette and Kinnard, 1995;Murphy et al, 2003;Pfanner et al, 2017;Radmer et al, 1999Radmer et al, , 2003Summers and Hubbard, 1984;Takwale et al, 2002;Vicar and Burton, 1986;Ward et al, 2011). The most common complications were implant dislocation and loosening, accounting for 20% and 14%, respectively, of all complications.…”