Comparative outcomes of total wrist arthrodesis for salvage of failed total wrist arthroplasty and primary wrist arthrodesis.

Mascha Wessels,Marco J P F Ritt,Hero J A Zijlker,Ruben K Fakkert,Cees B Ijsselstein,Annechien Beumer

doi:10.1177/17531934211057389

Abstract

A retrospective study compared outcomes of total wrist arthrodesis as a salvage for total wrist arthroplasty versus primary total wrist arthrodesis. Seventy-one wrists were reviewed after a minimum follow-up of 12 months. Thirty-two wrists with failed total wrist arthroplasty were converted to a wrist arthrodesis and 39 wrists received a primary wrist arthrodesis. Seven converted wrist arthrodeses and five primary arthrodeses failed to fuse. Mean patient-rated wrist and hand evaluation scores and work-related questionnaire for upper extremity disorders scores were 43 and 39 for converted total wrist arthrodesis and 38 and 33 for the primary total wrist arthrodesis. Overall, there were 25 complications in 15 patients in the converted wrist arthrodesis group and 21 complications in 16 patients after a primary wrist arthrodesis. The results between the two groups were slightly in favour of patients with a primary wrist arthrodesis. Therefore, we conclude that the timing, primary or conversion, of total wrist arthrodesis could influence patient outcomes.Level of evidence: III

Highlights

Rheumatoid arthritis and primary or post-traumatic osteoarthritis can cause degeneration of the wrist, which results in pain, limited range of motion and reduced grip strength
Failed Total wrist arthroplasty (TWA) can be salvaged by revision implant replacement or conversion to a total wrist arthrodesis (Zijlker et al, 2019)
Literature on the clinical outcomes of total wrist arthrodesis used as a salvage technique remains scarce with only reports of small series (Adams et al, 2016; Reigstad and Rokkum, 2014; Reigstad et al, 2017)

Summary

Introduction

Rheumatoid arthritis and primary or post-traumatic osteoarthritis can cause degeneration of the wrist, which results in pain, limited range of motion and reduced grip strength. Failed TWA can be salvaged by revision implant replacement or conversion to a total wrist arthrodesis (Zijlker et al, 2019). The latter comes with technical difficulties, such as severe bone loss after implant removal and poor quality of bone, especially in rheumatoid patients. Literature on the clinical outcomes of total wrist arthrodesis used as a salvage technique remains scarce with only reports of small series (Adams et al, 2016; Reigstad and Rokkum, 2014; Reigstad et al, 2017) The aim of this retrospective study was to evaluate

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Results

Conclusion