Reoperative Surgery in Failed Wrist Arthroplasty

  • Kevin J. RenfreeEmail author


Despite wrist arthritis and other degenerative conditions of the wrist being quite common, total wrist arthroplasty is a relatively uncommon procedure, especially when compared to arthroplasty about the hip, knee, and shoulder. Newer implants require minimal bone resection; however, not only are there still numerous older implants still in patients, but these newer implants can still have complications. Revising a wrist arthroplasty to another implant is believed to have a rather high complication and failure rate, although no large studies are available. In most cases of wrist arthroplasty revision, wrist arthrodesis will be considered the procedure of choice. Given bone loss, there is usually the need for a significant amount of structural bone grafting that can either be in the form of autograft or allograft. Plate fusion is most commonly utilized, but newer intramedullary fusion implants do offer some unique possibilities. In some circumstances, the wrist may be fused as a temporary measure to establish more bone stock, and then the wrist fusion taken down and a new arthroplasty implant placed. The patients suffering with these conditions frequently may have loss in finger range of motion secondary to scarring of the extensor and flexor tendons. The challenges of implant revisions should be thoroughly reviewed with the patient as there is the possibility of significant complications


Revision Total Wrist Arthroplasty Fusion 


  1. 1.
    Ferlic DC, Jolly SN, Clayton ML. Salvage for failed implant arthroplasty of the wrist. J Hand Surg Am. 1992;17(5):917–23.PubMedCrossRefGoogle Scholar
  2. 2.
    Davis RF, Weiland AJ, Dowling SV. Swanson implant arthroplasty of the wrist in rheumatoid arthritis. Clin Orthop Relat Res. 1982;166:132–7.PubMedGoogle Scholar
  3. 3.
    Rayan GM, Brentlinger A, Purnell D, Garcia-Moral CA. Functional assessment of bilateral wrist arthrodeses. J Hand Surg Am. 1987;12(6):1020–4.PubMedGoogle Scholar
  4. 4.
    Cavaliere C, Chung KC. A systematic review of total wrist arthroplasty compared with total wrist arthrodesis for rheumatoid arthritis. Plast Reconstr Surg. 2008;122:813–25.PubMedCrossRefGoogle Scholar
  5. 5.
    Jolly SL, Ferlic DC, Clayton ML, Dennis DA, Stringer EA. Swanson silicone arthroplasty of the wrist in rheumatoid arthritis: a long-term follow-up. J Hand Surg Am. 1992;17(1):142–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Beckenbaugh RD. Commentary: APH total wrist arthroplasty. J Hand Surg Am. 2003;28A:795–6.CrossRefGoogle Scholar
  7. 7.
    Talwalker SC, Hayton MJ, Trail IA, Stanley JK. Management of the failed biaxial wrist replacement. J Hand Surg Br. 2005;30(3):248–51.CrossRefGoogle Scholar
  8. 8.
    Capone RA. The titanium grommet in flexible implant arthroplasty of the radiocarpal joint: a long-term review of 44 cases. Plast Reconstr Surg. 1995;96(3):667–72.PubMedCrossRefGoogle Scholar
  9. 9.
    Cobb TK, Beckenbaugh RD. Biaxial long-stemmed multipronged distal components for revision/bone deficit in total-wrist arthroplasty. J Hand Surg Am. 1996;21(5):764–70.PubMedCrossRefGoogle Scholar
  10. 10.
    Palmer AK, Werner FW, Murphy D, Glisson R. Functional wrist motion: a biomechanical study. J Hand Surg Am. 1985;10:39.PubMedGoogle Scholar
  11. 11.
    Carlson JR, Simmons BP. Wrist arthrodesis after failed wrist implant. J Hand Surg Am. 1998;23:893–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Radmer S, Andresen R, Sparmann M. Total wrist arthroplasty in patients with rheumatoid arthritis. J Hand Surg Am. 2003;28A:789–94.CrossRefGoogle Scholar
  13. 13.
    Rettig ME, Beckenbaugh RD. Revision total wrist arthroplasty. J Hand Surg Am. 1993;18(5):798–804.PubMedCrossRefGoogle Scholar
  14. 14.
    Lorei MP, Figgie MP, Ranawat CS, Inglis AE. Failed total wrist arthroplasty. Clin Orthop Relat Res. 1997;342:84–93.PubMedCrossRefGoogle Scholar
  15. 15.
    Cooney WP, Beckenbaugh RD, Linscheid RL. Total wrist arthroplasty. Problems with implant failures. Clin Orthop Relat Res. 1984;87:121–8.Google Scholar
  16. 16.
    Takwale VJ, Nuttall D, Trail IA, Stanley JK. Biaxial total wrist replacement in patients with rheumatoid arthritis. J Bone Joint Surg Br. 2002;84-B:692–9.CrossRefGoogle Scholar
  17. 17.
    Mutimer JN, Giddins GEB. Maintaining wrist function in severe rheumatoid arthritis: a case study of revision Swanson wrist arthroplasty staged via a wrist fusion in rheumatoid arthritis. Hand Surg. 2002;7(2):183–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Dawson WJ. Radius fracture after total wrist arthroplasty. J Hand Surg Am. 1989;14(4):630–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Clayton M, Ferlic D. Silicone arthroplasty of the wrist in rheumatoid arthritis. (Letters to the Editor). J Hand Surg Am. 1993;18(1):166.CrossRefGoogle Scholar
  20. 20.
    Sollerman C, et al. One year result from an ongoing multicenter study of the Avanta wrist implant. Abstract presented at: Meeting of the International Federation of Societies for Surgery of the Hand, March 2007, Sydney, Australia.Google Scholar
  21. 21.
    Rettig ME, Beckenbaugh RD. Revision total wrist arthroplasty. J Hand Surg Am. 1993;18A:798–804.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryMayo Clinic HospitalPhoenixUSA

Personalised recommendations