Total wrist arthroplasty in rheumatoid arthritis. a long-term clinical review
Gellman, H.; Hontas, R.; Brumfield, R.H.; Tozzi, J.; Conaty, J.P.
Clinical Orthopaedics and Related Research 342: 71-76
1997
ISSN/ISBN: 0009-921X PMID: 9308527 Document Number: 483021
Fourteen total wrist arthroplasties performed in 13 patients with rheumatoid arthritis between 1978 and 1982 were reviewed to evaluate long term outcome. Most patients had Stages III or IV rheumatoid arthritis at the time of surgery. Pain was the primary presenting complaint in 87%. Average followup was 6.5 years (range, 3.5-11.5 years). Pain relief was achieved in 86% of patients. Using objective data obtained from their wrist scores, 72% of the patients had a good result, 14% had a fair result, and 14% had a poor result. No patient had an excellent result. Twenty-seven percent suffered postoperative complications related to their surgical procedure. Although these results help confirm the usefulness of total wrist arthroplasty as an alternative to arthrodesis of the wrist, it is a technically demanding procedure, and should be reserved for the patient who has severely involved arthritis. Additional improvements are needed to decrease the currently high complication and failure rate.