title: Wrist arthroplasty--a systematic review.
abstract: BACKGROUND
  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) has been used on a regular basis since the 1960's. 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 protocolled strategy and well-defined criteria in PubMed, in the Cochrane Library and by screening reference lists.
  
  
  RESULTS
  37 publications describing a total of 18 implants were selected for analysis. 16 of the publications were useful for the evaluation of implant longevity. Despite methodological shortcomings in many of the source documents, a summary estimate was possible.
  
  
  CONCLUSIONS
  It seems that T/PWA has a good potential to improve function through pain reduction and preservation of mobility. The risk of severe complications - deep infection and instability problems - is small with the available implants. Implant survival of 90-100% at five years are reported in most series - if not all - using newer second generation and third generation implants, but declines from five to eight years. Periprosthetic osteolysis/radiolucency is frequently reported. Its causes and consequences are not clarified.
authors.affiliation: Håndkirurgisk Afdeling Z, Gentofte Hospital, Niels Andersens Vej 65, 2900 Gentofte, Denmark. mibo@dadlnet.dk.
authors.forename: Michel E H
authors.initials: ME
authors.lastname: Boeckstyns
mesh_terms: D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000295:instrumentation*; D018737:Hand Strength; D006801:Humans; D007595:Joint Prosthesis; D011859:Radiography; D016059:Range of Motion, Articular; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*