Biaxial total-wrist arthroplasty.
Sixty-four consecutive biaxial total wrist arthroplasties performed in 52 patients between March 1983 and June 1988 were reviewed. Fifty-seven cases involving 45 patients were followed for a minimum of 5 years or until failure. Of the remaining 7 patients, 6 had died and 1 was lost to follow-up study. For the 46 intact implants in living patients, the mean follow-up period was 6.5 years (range, 5-9.9 years). The mean patient age at operation was 58 years. The underlying diagnosis was rheumatoid arthritis in 63 cases and juvenile rheumatoid arthritis in 1 case. At follow-up evaluation, pain was reported as none in 75%, mild in 19%, moderate in 3%, and severe in 3%. Patients rated their improvement as much better in 62%, better in 30%, some improvement in 4%, and worse in 4%. Range of motion at last follow-up averaged 36 degree extension, 29 degree flexion, 10 degree radial deviation, and 20 degree ulnar deviation. Grip strength improved from 4.1 kg preoperatively to 5.9 kg at last follow-up evaluation. Pain was likewise significantly improved at 1 year and 5 years. Failures occurred in 11 cases. The causes of failure were loosening of the distal implant in 8 cases and infection, dislocation, and progressive soft tissue imbalance in 1 case each. An abnormal resting stance and distal implant subsidence (> or = to 3 mm) at 1 year were associated with implant failure at final follow-up evaluation. The Kaplan-Meier probability of survival free of revision was 83% at last follow-up evaluation
Cobb
T K
TK
Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA.
Beckenbaugh
R D
RD
D000328:Adult; D000368:Aged; D001171:Arthritis, Juvenile / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D011859:Radiography; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*