Resection arthroplasty of the distal radioulnar joint (DRUJ), such as the Darrach procedure, is a common treatment for pathology that proves refractory to more conservative measures. Although outcomes are often favorable, complications include pain, instability, ulnar translation of the carpus, and abutment of the ulnar stump on the radius [7, 13]. Darrach procedures yield inferior outcomes in patients with high functional demands [7, 26] and numerous soft-tissue stabilization procedures have been developed to control an unstable residual ulnar stump [3, 4, 12]. Unfortunately, the failed distal ulnar resection has proved quite problematic, with persistently poor outcomes despite multiple stabilization procedures [2]. DRUJ implant arthroplasty offers a possible solution. Distal ulnar hemiarthroplasties exist [5, 10], as do total ulnar head replacements [8, 14, 20, 25], but their stability requires some contribution from native soft tissues, which are often deficient, especially in salvage situations [22]. More recently, total DRUJ replacements have been developed [11, 19, 23]. One particular implant is the bipolar, self-constrained Aptis Total DRUJ Replacement Prosthesis (Aptis Medical, Louisville, KY) [21, 22]. This report describes our experience with this new implant.