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Total wrist replacement arthroplasty

Sandra Pfanner, Giovanni Munz, Giulia Guidi, Massimo Ceruso
Purpose  The aim of this study was to evaluate the mid- to long-term outcomes and complications in patients affected by rheumatic diseases treated with the Universal 2 (U2) total wrist arthroplasty (TWA). Methods  We reviewed, in a retrospective, noncontrolled cohort study, 22 patients affected by rheumatoid arthritis (RA), who underwent U2 total wrist replacement between March 2003 and January 2014 for the treatment of 23 rheumatoid wrists with the aim of obtaining the remission of pain and a range of motion (ROM) useful for daily activities, according to the patients' demands, as an alternative to total wrist arthrodesis...
August 2017: Journal of Wrist Surgery
L S Moulton, G E B Giddins
The use of implant arthroplasty in the hand and wrist is increasing, often with little evidence of outcomes in the literature. We therefore undertook a systematic review of the outcomes of distal radio-ulnar joint arthroplasties following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Papers were assessed for outcomes, implant survival and methodological quality. Fourteen papers assessed ulna head replacements. The implant survival rate was 93% at a mean follow-up of 45 months...
February 1, 2017: Journal of Hand Surgery, European Volume
Ilse Degreef
Background The elbow joint is a complex compound articulation, with a linking role within the upper limb kinematics. Its hinge function allows for proper placement of our working instrument (the hand) in the space surrounding us, directed by the shoulder joint. Both reliable mobility and stability are essential elements to allow for consistent bridging of the distance we aim to achieve in common daily activities. Sufficient flexion and extension are required to ensure both the patients' independence and the dignity...
April 2016: Acta Chirurgica Belgica
Jin-Xing Ma, Yong-Qing Xu
Total wrist arthroplasty are not used as widely as total knee and hip replacement. The functional hands are requiring surgeons to design a durable and functional satisfying prosthesis. This article will list the main reasons that cause the failure of the prosthesis. Some remarkable and representative prostheses are listed to show the devolvement of total wrist prosthesis and their individual special innovations to fix the problems. And the second part we will discuss the part that biomechanical elements act in the total wrist replacement (TWA)...
2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Michael P Gaspar, Jesse Lou, Patrick M Kane, Sidney M Jacoby, A Lee Osterman, Randall W Culp
PURPOSE: To describe our institution's experience with complications following partial and total wrist arthroplasty (TWA). METHODS: We performed a retrospective review of 105 wrist surgeries in 100 patients who underwent surgery with prosthetic replacement of the distal radius, the proximal carpus, or both at a single institution. Patient factors including age, sex, body mass index, handedness, underlying disease, and previous injury were recorded. Outcomes focused particularly on postoperative complications and need for revision surgery...
January 2016: Journal of Hand Surgery
Antonio Rampazzo, Bahar Bassiri Gharb, Guy Brock, Luis R Scheker
PURPOSE: To study the functional results after Aptis-Scheker distal radioulnar joint (DRUJ) replacement in young patients. METHODS: We performed a retrospective study selecting all patients under age 40 years, with a clinical and radiological follow-up longer than 2 years, who underwent DRUJ replacement. Patients' charts were reviewed and age at surgery, profession, hobbies, comorbidities, diagnosis, previous procedures, and complications were recorded. Preoperative and postoperative Disabilities of Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores, visual analog scale score, grip strength, lifting capacity, and wrist range of motion were recorded...
July 2015: Journal of Hand Surgery
Dominik Rog, Lee M Zuckerman, Barth Riedel
Arthrodesis of the elbow joint addresses pain due to intra-articular pathology, but with significant functional limitations. Loss of motion at the elbow is not completely compensated by the wrist and shoulder joints and elbow fusion is thus purely a salvage procedure. Advances in joint arthroplasty have allowed surgeons to address the functional limitations of arthrodesis, but despite these advances the elbow is still one of the joint replacements with higher complication rate. Conversion of a joint fusion to arthroplasty has been reported for the hip, knee, shoulder, and ankle...
2015: Case Reports in Orthopedics
Klemens Trieb
In rheumatoid arthritis the small joints of the feet and hands are the first targets of the autoimmune process. In about one half of the patient the wrist is involved in the first stages of the disease (two years) increasing up to nearly 90 percent after a decade often including both sides. Osteoarthritis of the wrist is one of the most common conditions encountered by hand surgeons. One aim of all treatment options is to achieve the best possible hand function without pain. If conservative treatment fails, operative treatment is necessary...
September 18, 2014: World Journal of Orthopedics
Mark Henry
BACKGROUND: With advanced Kienböck's disease, hyaline cartilage delamination or bone fragmentation render the lunate unsalvageable. Common surgical options are proximal row carpectomy, scaphotrapeziotrapezoid fusion, scaphocapitate fusion, or total wrist fusion. The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes of one alternative: lunate prosthetic replacement arthroplasty combined with reconstruction of the scapholunate and lunotriquetral interosseous ligaments using the flexor carpi radialis tendon...
September 2014: Hand: Official Journal of the American Association for Hand Surgery
Manish Chug, Nicole Williams, David Benn, Stephen Brindley
BACKGROUND: Osteoarthritis of the trapeziometacarpal joint of thumb occurs frequently and can be very disabling. Numerous surgical techniques including trapeziectomy with or without tendon interposition arthrodesis and partial or total joint arthroplasty with cemented and noncemented prosthesis have been described for the treatment of trapeziometacarpal joint osteoarthritis. Initial problems of osteolysis and implant loosening have been substantially reduced with improvement in implant design...
July 2014: Indian Journal of Orthopaedics
Ingo Schmidt
UNLABELLED: This is a case report of a 59-year-old female patient with a posttraumatic growth arrest of the distal radius, leading to radioscaphoid osteoarthritis, carpal instability, and a symptomatic ulnocarpal impaction syndrome that was successfully treated with combined total wrist arthroplasty and ulnar head implant. One year postoperatively, there was no change in position without any signs of loosening of both implants. Both subjectively and functionally, all clinical parameters-Disabilities of the Arm, Shoulder, and Hand (DASH), visual analog scale (VAS), grip strength-had improved...
August 2014: Journal of Wrist Surgery
Elkin J Galvis, Joel Pessa, Luis R Scheker
PURPOSE: To evaluate the clinical and radiological results of primary total distal radioulnar joint (DRUJ) replacement as well as reconstruction following ulnar head excision in patients with rheumatoid arthritis (RA). METHODS: Seventeen patients with RA underwent 19 total DRUJ replacement between 2005 and 2011. Mean age at the time of the surgery was 57 years. Mean follow-up was 39 months (range, 12-79 mo). Pain level was evaluated using a visual analog scale (VAS)...
September 2014: Journal of Hand Surgery
D Yeoh, L Tourret
We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3-7.3 years with an average age of 52-63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3-5 years), while Elos had the lowest (57% at 5 years)...
June 2015: Journal of Hand Surgery, European Volume
Shigeki Momohara, Eisuke Inoue, Katsunori Ikari, Kensuke Ochi, Osamu Ishida, Koichiro Yano, Yu Sakuma, Shinji Yoshida, Takuma Koyama, Naoko Koenuma, Atsuo Taniguchi, Hisashi Yamanaka
OBJECTIVE: To describe current trends in the numbers of rheumatoid arthritis (RA)-related surgeries. METHODS: The number of operations was determined for patients with RA in a large observational cohort [Institute of Rheumatology, Rheumatoid Arthritis (IORRA)] enrolled from 2001 to 2012. RESULTS: The total number of operations peaked in 2002 and gradually decreased thereafter, but began to increase again in 2008. The number of total knee replacements has decreased since 2003, while the number of wrist and foot arthroplasties and the number of artificial finger prosthesis surgeries have increased gradually...
May 2014: Journal of Rheumatology
William Cooney, Jennifer Manuel, John Froelich, Marco Rizzo
Purpose Total wrist arthroplasty (TWA) is an evolving procedure for the treatment of arthritis of the wrist joint. The purpose of this study is to compare outcomes of three different total wrist implants. Methods A retrospective review of the Biaxial, Universal 2, and Re-Motion total wrist arthroplasties was performed. Patients were evaluated for clinical outcome, radiographic analysis, review of complications (incidence and type), and conversion to wrist fusion. Patient function measures included: the Mayo wrist score, the Patient Related Wrist Evaluation, and Disabilities of Arm, Shoulder, and Hand (DASH) score...
November 2012: Journal of Wrist Surgery
R Thorkildsen, J Theodorsson, M Mellgren, M Røkkum
Trapezium components from two uncemented total joint replacements were compared in a three-dimensional finite element model. A 100 N axial and angular load was applied in a normal and an osteoporotic bone model. The axial deformation and maximum periprosthetic stress are greater for the Elektra than the Motec CMC cup. The Motec CMC design is less sensitive to changing bone quality. The Elektra cup transmits more stress to the cortical bone rim in all load conditions, but under angular loading the proportionate increase in stress is lower...
2013: Hand Surgery
A S C Bidwai, F Cashin, A Richards, D J Brown
We present the clinical outcome of patients who underwent RE-MOTION Total Wrist Replacement (TWR) for the treatment of Rheumatoid arthritis involving the wrist. Ten patients were available for follow-up, ranging from one to five years after index surgery. Two patients required surgical intervention for wound breakdown, including one patient who required a radial forearm flap for skin coverage. No patients required revision surgery or conversion to fusion. Patients who did not have complications gained statistically significant pain relief and improvement in mean overall flexion...
2013: Hand Surgery
Yasmin Khan, Sujith Konan, Elliot Sorene
This study reports a case of revision of a failed Swanson silastic interpositional wrist replacement to a Universal 2 (KMI Medical Inc., San Diego, CA, Jan 2009) total wrist arthroplasty, in a 68-year-old woman with rheumatoid arthritis and pyrophosphate arthropathy. At the 2-year follow-up, the patient was pain-free and was able to perform all activities of daily living, documented by subjective assessment and objective scores. The disabilities of the arm, shoulder, and hand (DASH) scores improved from 98...
April 2014: Journal of Plastic Surgery and Hand Surgery
Zubin J Daruwalla, Kirstenlee Davies, Ali Shafighian, Nicholas R Gillham
INTRODUCTION: Scaphoid nonunion advanced collapse (SNAC) and radioscaphoid osteoarthritis are difficult to treat. Options include proximal row carpectomy (PRC), four corner fusion (4CF) and wrist arthroplasty or arthrodesis. However, with inevitable disease progression, a significant proportion of patients undergo total wrist fusion. This reduces function by abolishing wrist movement. We review the preliminary results of a pyrocarbon interpositional radiocarpal implant in a small cohort of patients from our prospective study and challenge the assumption that there are no surgical alternatives...
June 2013: Annals of the Academy of Medicine, Singapore
Peter Axelsson, Christer Sollerman
PURPOSE: To evaluate the clinical and radiological outcomes for the Scheker total joint endoprosthesis when used for previously failed surgeries of the distal radioulnar joint (DRUJ). METHODS: Eight patients with DRUJ derangement with painful instability and 1 patient with DRUJ synostosis received a Scheker DRUJ total joint endoprosthesis between 2006 and 2010. All patients had at least 1 procedure previously performed on the distal ulna (mean, 3.6 procedures). The follow-up time was on average 3...
June 2013: Journal of Hand Surgery
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