New Total Wrist Prosthesis

Severe wrist arthritis has traditionally been treated by complete fusion of the joint; however, the lost motion may adversely impact one’s ability to perform even simple tasks, especially when multiple joints are afflicted by arthritis. Although attempts at total wrist replacement have historically been fraught with complications, we recently completed a clinical study on the early outcome of wrist replacement for rheumatoid patients using a recent generation prosthesis.

Excellent pain relief, good motion, and high patient satisfaction were consistently achieved and matched the results of the prosthesis’ inventor who reported a longer term follow up. Most promising was the durability of implant fixation, which was a major problem with previous designs. Unfortunately, prosthetic dislocation has been at common complication and the need for cement may increase the risk of loosening.

Building on clinical experience and laboratory studies of previous prostheses, we designed and developed a new wrist prosthesis for improved performance. Our work in the biomechanics laboratory resulted in an implant with an articulation having greater stability and less potential for wear. In addition, the design closely mimics the normal wrist anatomy for better fit and function. Finally, our goal is to achieve a reliable prosthesis for patients with greater physical demands and thus it can implanted without cement when indicated.

Several patients from Iowa and other states have received the new prosthesis and the early results have met our expectations. We are closely monitoring these patients with detailed pre and postoperative motion tracking systems and multiple outcome surveys in order to show the real benefit gained from retaining wrist motion.

Seeing and hearing the positive feedback from patients has made this combined laboratory and clinical endeavor most satisfying. The comprehensive outcome data that will be gathered from our ongoing prospective clinical study of this prosthesis will provide important feedback to both physician and patients.

- Brian D. Adams, MD and Nicole M. Grosland, PhD

Universal 2 Surgical Technique(.pdf)

Biomechanical Evaluation of a New Prosthesis Design for Use in Total Wrist Arthroplasty(.pdf)

Case Examples

• Patient 1
• Patient 2
• Patient 3