title: Intermediate outcomes of ulnar head arthroplasty.
abstract: OBJECTIVE
  To determine the survivorship and clinical outcomes of ulnar head arthroplasty.
  
  
  METHODS
  The study design included a review of medical records and clinical assessment of all patients who had an ulnar head arthroplasty more than 2 years previously. Survivorship of 79 implants in 74 patients was determined. Forty-seven of these patients participated in a clinical review using the Patient Examination Measure, Patient-Related Wrist Examination, Wrightington Wrist Score, and EQ5D to measure outcomes. Analysis of outcomes was performed for diagnostic subgroups (inflammatory arthritis, posttraumatic, osteoarthritis/impingement, and other), primary versus revision surgery, and whether the procedure was performed for ulnar stump instability (related to either a previous Darrach or Sauvé-Kapandji procedure).
  
  
  RESULTS
  The 5- and 15-year survival of the implants was 90% for both, with mean follow-up of 7 ± 4 years. Mean age at surgery was 50 ± 13 years (range, 24-76). Mean range of motion was within the functional range and grip strength was 67% that of the contralateral side. Patient satisfaction was generally high, but outcomes scores indicated substantial residual disability. Overall scores were 41 for the Patient Examination Measure, 52 for the Patient-Related Wrist Examination, and 70 for the WWS. Patients in the "other" category had the worst scores for all measures. Patients with prior wrist surgery had poorer outcomes than those for whom the arthroplasty was a primary procedure. Patients with posttraumatic diagnoses had worse EQ5D scores and were less likely to recommend the procedure to others.
  
  
  CONCLUSIONS
  Ulnar head arthroplasty had good long-term survival and acceptable patient satisfaction. Substantial disability remained in all groups, with the posttraumatic, "other", and revision groups faring worse. Patients should be counseled about the expected outcomes of this specialized procedure as they pertain to the patient's specific situation.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: University of Calgary, Canada; Wrightington Hospital, Wigan, UK. Electronic address: marlis.sabo@gmail.com.
authors.forename: Marlis T
authors.initials: MT
authors.lastname: Sabo
authors.affiliation: University of Calgary, Canada; Wrightington Hospital, Wigan, UK.
authors.forename: Sumedh
authors.initials: S
authors.lastname: Talwalkar
authors.affiliation: University of Calgary, Canada; Wrightington Hospital, Wigan, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Hayton
authors.affiliation: University of Calgary, Canada; Wrightington Hospital, Wigan, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Watts
authors.affiliation: University of Calgary, Canada; Wrightington Hospital, Wigan, UK.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Trail
authors.affiliation: University of Calgary, Canada; Wrightington Hospital, Wigan, UK.
authors.forename: John K
authors.initials: JK
authors.lastname: Stanley
mesh_terms: D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000601:surgery; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014457:Ulna / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*
keywords: DRUJ; Distal radioulnar joint; arthroplasty; ulnar head replacement; wrist arthritis