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Total Wrist Arthroplasty

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Kienböck’s Disease

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Abstract

Total wrist arthroplasty (TWA) is still today a very controversial issue but it has become a challenger of total wrist fusion (TWF). According to the literature TWA is rarely performed for Kienböck’s disease (KD). The indication is for the salvage of the painful wrist, in which TWF would be the only alternative option, which means a Lichtman stage IV. The latest generation of TWA is generally characterized by limited bone resection and restricts fixation of the distal component in the metacarpals compared with older designs: fixation is mainly secured in the carpal bones. Still, one available implant uses a large screw for fixation in the third metacarpal. Hemiarthroplasty, using a single component fixated in the radius, and an interpositional pyrocarbon implant are also available.

Cumulated implant survival rates of up to 90 % at 9 years have been reported. The motion that can be achieved seems to be dependent on the preoperative mobility and does not improve significantly in all published series. Function, evaluated by the DASH or PRWE questionnaires, generally improves significantly. Patients operated bilaterally generally prefer TWA but the question as to which extent and on what indications TWA is superior to TWF still needs to be answered definitively.

In conclusion, when dealing with an elderly low demand patient, who requires a surgical salvage procedure, such as Lichtman stage IV wrist and especially if there is bilateral wrist involvement, TWA may be an option if motion is to be preserved.

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References

  1. Cavaliere CM, Oppenheimer AJ, Chung KC. Reconstructing the rheumatoid wrist: a utility analysis comparing total wrist fusion and total wrist arthroplasty from the perspectives of rheumatologists and hand surgeons. Hand. 2010;5(1):9–18. doi:10.1007/s11552-009-9194-7.

    Article  PubMed  Google Scholar 

  2. Cavaliere CM, Chung KC. A systematic review of total wrist arthroplasty compared with total wrist arthrodesis for rheumatoid arthritis. Plast Reconstr Surg. 2008;122(3):813–25. doi:10.1097/PRS.0b013e318180ece3.

    Article  CAS  PubMed  Google Scholar 

  3. Cavaliere CM, Chung KC. Total wrist arthroplasty and total wrist arthrodesis in rheumatoid arthritis: a decision analysis from the hand surgeons’ perspective. J Hand Surg Am. 2008;33(10):1744–55. doi:10.1016/j.jhsa.2008.06.022. 55.e1-2.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Trieb K. Treatment of the wrist in rheumatoid arthritis. J Hand Surg Am. 2008;33(1):113–23. doi:10.1016/j.jhsa.2007.09.011.

    Article  PubMed  Google Scholar 

  5. Murphy DM, Khoury JG, Imbriglia JE, Adams BD. Comparison of arthroplasty and arthrodesis for the rheumatoid wrist. J Hand Surg Am. 2003;28(4):570–6.

    Article  PubMed  Google Scholar 

  6. Boeckstyns ME. Wrist arthroplasty--a systematic review. Dan Med J. 2014;61(5):A4834.

    PubMed  Google Scholar 

  7. Adey L, Ring D, Jupiter JB. Health status after total wrist arthrodesis for posttraumatic arthritis. J Hand Surg Am. 2005;30(5):932–6. doi:10.1016/j.jhsa.2005.06.004.

    Article  PubMed  Google Scholar 

  8. Sauerbier M, Kania NM, Kluge S, Bickert B, Germann G. Initial results of treatment with the new AO wrist joint arthrodesis plate. Handchir Mikrochir Plast Chir. 1999;31(4):260–5. doi:10.1055/s-1999-13536.

    Article  CAS  PubMed  Google Scholar 

  9. Adams BD. Complications of wrist arthroplasty. Hand Clin. 2010;26(2):213–20. doi:10.1016/j.hcl.2010.01.006.

    Article  PubMed  Google Scholar 

  10. Menon J. Universal total wrist implant: experience with a carpal component fixed with three screws. J Arthrop. 1998;13(5):515–23.

    Article  CAS  Google Scholar 

  11. Ferreres A, Lluch A, Del Valle M. Universal total wrist arthroplasty: midterm follow-up study. J Hand Surg Am. 2011;36(6):967–73. doi:10.1016/j.jhsa.2011.03.034.

    Article  PubMed  Google Scholar 

  12. van Winterswijk PJ, Bakx PA. Promising clinical results of the universal total wrist prosthesis in rheumatoid arthritis. Open Orthop J. 2010;4:67–70. doi:10.2174/1874325001004020067.

    PubMed  PubMed Central  Google Scholar 

  13. Herzberg G. Prospective study of a new total wrist arthroplasty: short term results. Chir Main. 2011;30(1):20–5. doi:10.1016/j.main.2011.01.017.

    Article  CAS  PubMed  Google Scholar 

  14. Herzberg G, Boeckstyns M, Ibsen Sørensen A, Axelsson P, Kroener K, Liverneaux P, et al. “Remotion” total wrist arthroplasty: preliminary results of a prospective international multicenter study of 215 cases. J Wrist Surg. 2012;01(01):17–22.

    Article  Google Scholar 

  15. Boeckstyns ME, Herzberg G, Merser S. Favorable results after total wrist arthroplasty: 65 wrists in 60 patients followed for 5-9 years. Acta Orthop. 2013;84(4):415–9. doi:10.3109/17453674.2013.823588.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Boeckstyns MEH, Herzberg G. Periprosthetic osteolysis after total wrist arthroplasty. J Wrist Surg. 2014;3(2):101–6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bidwai AS, Cashin F, Richards A, Brown DJ. Short to medium results using the remotion total wrist replacement for rheumatoid arthritis. Hand Surg. 2013;18(2):175–8. doi:10.1142/S0218810413500202.

    Article  CAS  PubMed  Google Scholar 

  18. Nydick JA, Greenberg SM, Stone JD, Williams B, Polikandriotis JA, Hess AV. Clinical outcomes of total wrist arthroplasty. J Hand Surg Am. 2012;37(8):1580–4. doi:10.1016/j.jhsa.2012.05.016.

    Article  PubMed  Google Scholar 

  19. Sagerfors M, Gupta A, Brus O, Rizzo M, Pettersson K. Patient related functional outcome after total wrist arthroplasty: a single center study of 206 cases. Hand Surg. 2015;20(1):81–7. doi:10.1142/S0218810415500112.

    Article  PubMed  Google Scholar 

  20. Palmer AK, Werner FW, Murphy D, Glisson R. Functional wrist motion: a biomechanical study. J Hand Surg Am. 1985;10(1):39–46.

    Article  CAS  PubMed  Google Scholar 

  21. Takwale VJ, Nuttall D, Trail IA, Stanley JK. Biaxial total wrist replacement in patients with rheumatoid arthritis. Clinical review, survivorship and radiological analysis. J Bone Joint Surg Br. 2002;84(5):692–9.

    Article  CAS  PubMed  Google Scholar 

  22. Nydick JA, Watt JF, Garcia MJ, Williams BD, Hess AV. Clinical outcomes of arthrodesis and arthroplasty for the treatment of post-traumatic wrist arthritis. J Hand Surg Am. 2013;38(5):899–903. doi:10.1016/j.jhsa.2013.02.013.

    Article  PubMed  Google Scholar 

  23. Morapudi SP, Marlow WJ, Withers D, Ralte P, Gabr A, Waseem M. Total wrist arthroplasty using the Universal 2 prosthesis. J Orthop Surg. 2012;20(3):365–8.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Clinic for Hand Surgery, Gentofte Hospital/University of Copenhagen, Niels Andersens Vej 65, Hellerup, 2900, Denmark

    Michel E. H. Boeckstyns MD, PhD

  2. Kloeverbakken 11, 2830, Virum, Denmark

    Michel E. H. Boeckstyns MD, PhD

  3. Department of Orthopedic Surgery, Hopital Edouard Herriot, Pavillon T, Upper Limb Surgery, 5 Place d’Arsonval, Lyon, 69437, France

    Guillaume Herzberg MD, PhD

Authors
  1. Michel E. H. Boeckstyns MD, PhD
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  2. Guillaume Herzberg MD, PhD
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Corresponding author

Correspondence to Michel E. H. Boeckstyns MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

    David M. Lichtman

  2. Department of Orthopedic Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia

    Gregory Ian Bain

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© 2016 Springer International Publishing Switzerland

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Boeckstyns, M.E.H., Herzberg, G. (2016). Total Wrist Arthroplasty. In: Lichtman, D., Bain, G. (eds) Kienböck’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-34226-9_28

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  • DOI: https://doi.org/10.1007/978-3-319-34226-9_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34224-5

  • Online ISBN: 978-3-319-34226-9

  • eBook Packages: MedicineMedicine (R0)

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