What is total wrist replacement surgery?
Total wrist replacement surgery – also known as “total wrist arthroplasty” – is a joint replacement procedure that is used to treat severe arthritis of the wrist. During the procedure, the degenerated parts of the wrist bones are replaced with metal and polyethylene components. These sophisticated wrist bone implants allow the patient to have pain free motion once more.
In the procedure, a radial component is inserted into the radial bone of the arm; this component has a flat metal piece with a plastic cup on the end. A distal component is inserted into the bone in the hands; the distal component has a globe-shaped piece of metal that fits into the radial component’s plastic socket. The new ball and socket joint provides much improved wrist function for patients suffering from arthritis.
Is that the same as wrist fusion?
Not at all. In a wrist fusion (arthrodesis) procedure, the actual carpal bones in the hand are permanently fused with a metal plate to the radius (the inner bone of the forearm). Wrist fusions limit patient mobility. Tasks that require finger dexterity – such as typing or playing a musical instrument – may prove difficult for patients who have a wrist fusion. Wrist fusion tends to be quite successful for patients who need more strength, but less dexterity.
In contrast, a total wrist arthroplasty provides much more dexterity and range of motion than wrist fusion. However, the implants’ lifespan may be limited if you regularly subject the wrist to intense physical activity.
Who needs total wrist arthroplasty?
Individuals who suffer from rheumatoid arthritis, post-traumatic arthritis, or osteoarthritis may be candidates for total wrist replacement surgery. Learn more about these conditions and their symptoms below:
Rheumatoid Arthritis (RA) is a systemic inflammatory disease that primarily affects the joints (though the disease can damage any part of the body). RA tends to affect smaller joints, such as those in the hands and feet. The condition can develop at any age, but is more common in patients over the age of 40. It is more prevalent in women than men. Symptoms may include: joints that are tender, warm, and swollen, fatigue, fever, weight loss, stiffness in the morning (may last for several hours), and rheumatoid nodules – hard tissue lumps and bumps beneath the skin.
Osteoarthritis (OA) is a degenerative disease the affects smooth articular cartilage, which covers the ends of bones. Once the cartilage in the wrist has been worn away, severe wrist pain may follow. Because cartilage cannot be replaced, treatment is necessary.
Post-Traumatic Arthritis is the inflammation and wearing away of a joint that has sustained some form of trauma. Trauma could include a car accident, fall, sports injury, or other occurrence. Post-traumatic arthritis can lead to osteoarthritis. Symptoms include joint pain, swelling, and – as a result – limited mobility, which may cause symptoms to worsen.
Are there other options besides total wrist arthroplasty?
Yes. Your hand surgeon at Hedley Orthopaedic Institute will evaluate your wrist and inform you of your various treatment options. The number of treatment options available to you may depend on the severity of your symptoms and the degree of cartilage loss your wrist has sustained. Alternative treatments that may be available include:
- Behavioral changes (i.e. avoiding activities that worsen symptoms)
- Wearing a wrist splint
- Use of NSAIDs, such as ibuprofen
- Steroid injections
- Full or partial wrist fusion surgery
- Stem cell injections
- Platelet-rich plasma injections
At Hedley Orthopaedic Institute, your hand surgeon will discuss all of your options with you prior to scheduling an operation for total wrist joint replacement surgery. To schedule an appointment with an orthopaedic surgeon in Phoenix, Tempe, or Mesa, contact us.