title: Complications Following Partial and Total Wrist Arthroplasty: A Single-Center Retrospective Review.
abstract: OBJECTIVE
  To describe our institution's experience with complications following partial and total wrist arthroplasty (TWA).
  
  
  METHODS
  We performed a retrospective review of 105 wrist surgeries in 100 patients who underwent surgery with prosthetic replacement of the distal radius, the proximal carpus, or both at a single institution. Patient factors including age, sex, body mass index, handedness, underlying disease, and previous injury were recorded. Outcomes focused particularly on postoperative complications and need for revision surgery.
  
  
  RESULTS
  Forty-seven TWAs, 52 distal radius hemiarthroplasties, and 6 proximal carpal hemiarthroplasties were reviewed with a mean follow-up duration of 35 ± 28 months. Overall complication and revision rates were 51% (53 of 105) and 39% (41 of 105), respectively. Postoperative contracture accounted for the largest number of complications needing additional surgery (20%), followed by component failure (15%). Deep infections occurred in 2 TWAs and 1 distal radius hemiarthroplasty and required removal of hardware, antibiotic spacer placement, and a prolonged course of intravenous antibiotics prior to a definitive operation. Of those patients requiring additional surgery, 41% (n = 10) underwent at least 2 procedures, and 10% (n = 4) underwent at least 6 additional surgeries.
  
  
  CONCLUSIONS
  Although TWA and partial wrist arthroplasty are attractive treatment options for the painful arthritic wrist, there remains a noteworthy potential for complications requiring additional surgery. A detailed understanding of these risks is essential for surgeons so that patients may be counseled accordingly and that alternative treatment options may be considered.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Philadelphia Hand Center, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA. Electronic address: michaelpgaspar@gmail.com.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gaspar
authors.affiliation: Philadelphia Hand Center, Philadelphia, PA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Lou
authors.affiliation: Philadelphia Hand Center, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kane
authors.affiliation: Philadelphia Hand Center, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Jacoby
authors.affiliation: Philadelphia Hand Center, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: A Lee
authors.initials: AL
authors.lastname: Osterman
authors.affiliation: Philadelphia Hand Center, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Randall W
authors.initials: RW
authors.lastname: Culp
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000379:methods*; D003286:Contracture / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000628:therapy; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014955:Wrist Joint / Q000601:surgery*
keywords: Complications; TWA; hemiarthroplasty; revision surgery; total wrist arthroplasty