Wrist arthroplasty – a systematic review

INTRODUCTION

Severely painful or dysfunctional, destroyed wrists can be reconstructed by fusion, interposition of soft tissue or by arthroplasty using artificial materials. Total and partial wrist arthroplasty (T/PWA) have been used on a regular basis since the 1960s. The objective of this study was to review the literature on second, third and fourth generation implants.

METHODS

The review was conducted according to the PRISMA – guidelines. A search was made using a protocoled strategy and well-defined criteria in PubMed, in the Cochrane Library and by screening reference lists.

RESULTS

Thirty-seven publications describing a total of 18 implants were selected for analysis. Sixteen of the publications were used for the evaluation of implant longevity. Despite methodological shortcomings in many of the source documents, it was possible to make a summary estimate.

CONCLUSION

It seems that T/PWA has a good potential to improve function through pain reduction and preservation of mobility. The risk of severe complications in the form of deep infection and instability problems is small with the available implants. Implant survival rates of 90-100% at five years are reported in most, if not all, of the series using newer 2nd generation and 3rd generation implants, but survival rates decline from five to eight years. Periprosthetic osteolysis/radiolucency is frequently reported. Its causes and consequences are not clarified.

CORRESPONDENCE: Michel E. H. Boeckstyns. E-mail: mibo@dadlnet.dk

CONFLICTS OF INTEREST: none. Disclosure forms provided by the authors are available with the full text of this article at www.danmedj.dk.

REFERENCE: Dan Med J 2014;61(5):A4834