Clinical, Radiographic, and Patient-Perceived Outcome After Radial Hemi-Wrist Arthroplasty With a New Implant: 20 Cases With 5-Year Follow-up

Reiser, Daniel,1972-Department of Orthopaedic and Hand Surgery, Faculty of Medicine and Health, Örebro University, Sweden (author)

Clinical, Radiographic, and Patient-Perceived Outcome After Radial Hemi-Wrist Arthroplasty With a New Implant : 20 Cases With 5-Year Follow-up

BACKGROUND: Distal component loosening is a common mode of failure in total wrist arthroplasty (TWA). A radial hemi-wrist arthroplasty (RHWA) has the potential to avoid problems related to the distal component in TWA. The aim of this study is to investigate clinical outcomes following surgical treatment with a new RHWA design.METHODS: In this pilot study of 20 consecutive RHWAs, patients were assessed preoperatively and postoperatively for range of motion, grip strength, Visual Analog Scale (VAS) pain scores, and functional scoring using Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH), and Canadian Occupational Performance Measure. Radiographs were analyzed at 12 months and 5 years (mean, 5.1 years) postoperatively.RESULTS: A total of 46 secondary surgeries were undertaken in 16 wrists, including 7 revisions. Another 6 patients are waiting for revision to radiocarpal arthrodesis. In non-revised patients, the DASH and PRWE scores improved, and wrist range of motion remained largely unchanged except for wrist flexion, which decreased. The VAS pain score during activity was reduced, and hand grip strength remained largely unchanged.CONCLUSIONS: The new implant resulted in improved functional scoring and improved VAS pain scores in non-revised patients, but many cases needed secondary surgery due to persistent pain. The high revision rate is a major concern, and further use of the implant in its current form cannot be recommended.

Sagerfors, Marcus,MD, PhD,1977-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopaedic and Hand Surgery, Faculty of Medicine and Health, Örebro University, Sweden(Swepub:oru)msss (author)
Wretenberg, Per,1963-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopaedic and Hand Surgery, Faculty of Medicine and Health, Örebro University, Sweden(Swepub:oru)pewg (author)
Pettersson, KurtDepartment of Orthopaedic and Hand Surgery, Faculty of Medicine and Health, Örebro University, Sweden (author)
Fischer, PerDepartment of Orthopaedic and Hand Surgery, Faculty of Medicine and Health, Örebro University, Sweden; Karlskoga Hospital, Sweden (author)
Department of Orthopaedic and Hand Surgery, Faculty of Medicine and Health, Örebro University, SwedenInstitutionen för medicinska vetenskaper (creator_code:org_t)

By the author/editor: Reiser, Daniel, ...; Sagerfors, Marcu ...; Wretenberg, Per, ...; Pettersson, Kurt; Fischer, Per

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Orthopaedics

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