title: Universal total wrist arthroplasty: midterm follow-up study.
abstract: OBJECTIVE
  We reviewed 21 consecutive patients who underwent a total wrist arthroplasty as a primary procedure between October 2001 and February 2007. The purposes of the present study were to communicate our midterm results and to compare them with previously published series.
  
  
  METHODS
  We evaluated all patients clinically and radiologically. We used the Patient-Related Wrist Evaluation a primary outcome measure. The mean follow-up was 5.5 years (range, 3-8 years). A total of 14 patients had rheumatoid arthritis, including 1 with juvenile arthritis, and 1 each had psoriatic arthritis, systemic lupus erythematosus, and undifferentiated spondyloarthropathy. Of the remaining 4 patients, 2 had grade IV Kienböck disease, 1 had degenerative arthrosis, and 1 had chondrocalcinosis.
  
  
  RESULTS
  Postoperative Patient-Related Wrist Evaluation scores averaged 24 points (SD, 21 pints) out of 100 (worst score). When the patients were specifically asked about pain and function of the arthroplasty, 20 claimed to be satisfied or very satisfied with the procedure. Two early and 3 late complications occurred. One patient had a wound hematoma and another had a superficial wound infection, both of which resolved with no further complications during the immediate postoperative period. In 2 patients, there was some osteolysis around the screw inserted into the medullary canal of the index metacarpal, but not in the trapezoid bone. One patient had a slight loosening of the distal component with subsidence on the ulnar side of the carpus. There have been no dislocations or surgical revisions of the components.
  
  
  CONCLUSIONS
  Based on our study, a total wrist arthroplasty should be considered as a good alternative to arthrodesis for patients who wish to preserve some degree of mobility of the wrist.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Surgery of the Hand and Upper Extremity, Institut Kaplan, Barcelona, Spain. angelferreres@institut-kaplan.com
authors.forename: Angel
authors.initials: A
authors.lastname: Ferreres
authors.forename: Alberto
authors.initials: A
authors.lastname: Lluch
authors.forename: Montserrat
authors.initials: M
authors.lastname: Del Valle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001171:Arthritis, Juvenile / Q000601:surgery*; D015535:Arthritis, Psoriatic / Q000601:surgery*; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods*; D001863:Bone Screws; D002805:Chondrocalcinosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D010020:Osteonecrosis / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D020959:Polyethylene; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011475:Prosthesis Failure / Q000209:etiology; D011859:Radiography; D012086:Reoperation; D014955:Wrist Joint / Q000601:surgery*
chemical_list: D020959:Polyethylene