Revision surgery for failed total wrist arthroplasty

Abstract

Introduction Third generation implants for total wrist arthroplasty (TWA) has now been available for more than 17 years. Consequently, an increasing number need revision. Aims of the study To report on our experience with revision surgery after failed TWA. Methods We prospectively and consecutively collected data on all TWA's that were revised in two clinics and made a general follow-up examination in May–June 2015. Findings We revised a total of 19 cases - 8 with rheumatoid arthritis, 11 with other diagnoses. Twelve were revised to a remotion TWA, 1 to an Amandys interposition implant and 6 were fused. At final follow-up, at an average of 31 months after operation, median improvement in QuickDASH score was 25 points, median improvement in VAS score for pain was 50 points. Three revisions TWA had been re-revised and 1 was loose and scheduled for re-revision. There was no difference in QuickDASH- or in VAS score between patients with fusion and patients with TWA. Conclusions Both fusion and revision to a new TWA are feasible after a failed TWA. Revision to a new TWA may require supplementary major procedures.