A 59-year-old right handed female was diagnosed with rheumatoid arthritis 15 years ago. She complained of right wrist stiffness and pain that has gradually worsened over the last few years, which now interferes with routine activities.

Both wrists had significantly reduced movement on examination, with the right more limited than the left. She expressed discomfort at the limits of motion. There was moderate swelling and mild deformity of the wrist, with intermittent crepitance during movement.

Preoperative x-rays

PA and lateral views of the right wrist joint show advanced arthritis marked by loss of joint spaces and erosions. Although there is some skeletal deformity, overall alignment of the wrist is generally preserved.

Postoperative x-rays for Patient 1

A small prosthesis has been implanted without cement. Alignment of the prosthesis is good.

Followup

She is pleased with her result. Wrist pain has been alleviated and the prosthetic motion allows her to perform daily activities without restrictions. She reports the wrist feels natural and stable.

Examination of the wrist reveals no swelling or tenderness. Wrist has 35° of flexion and 30° of extension. Radial deviation is 15° and ulnar deviation is 10°. She has full forearm rotation. The prosthesis is stable during all motion.