title: High rate of complications and radiographic loosening of the biaxial total wrist arthroplasty in rheumatoid arthritis: 32 wrists followed for 6 (5–8) years.
abstract: OBJECTIVE
  The third generation of total wrist arthroplasty (TWA) was designed to solve the early loosening problem, but there have been few long-term follow-ups. We present the outcome of the biaxial total wrist prosthesis (no longer available) after 5-8 years of follow-up.
  
  
  METHODS
  40 biaxial wrist prostheses were implanted uncemented in 36 patients with rheumatoid arthritis. 32 wrists were followed clinically and radiographically. 7 prostheses had been revised at median 21 (8-71) months; 1 patient died from an unrelated cause. Mean follow-up of the remaining 32 wrists was 6 (5-8) years. Kaplan-Meier survival analysis was performed with revision defined as failure.
  
  
  RESULTS
  Survival after 7 years was 81% (95% CI: 64-91). There were 31 complications. 22 wrists showed radiographic loosening. Range of motion improved, except for pronation. The mean DASH score improved and the median postoperative pain score (from 0 to 10) was 0 (0-6) at rest and 0 (0-7) during activity.
  
  
  CONCLUSIONS
  One quarter of the prostheses had been revised and radiographic loosening had occurred in two thirds of the cases. Radiographic and clinical follow-up is therefore necessary for patients with this implant.
authors: Department of Orthopaedics, Sint Maartenskliniek, Nijmegen, the Netherlands.
authors: Djoeke van
authors: Dv
authors: Harlingen
authors: Petra J C
authors: PJ
authors: Heesterbeek
authors: Maarten
authors: M
authors: J de Vos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult