What is wrist joint replacement and how can it benefit me?

The traditional surgical approach to the treatment of advanced wrist arthritis is fusion of the joint. Fusion will effectively reduce pain and improve grip strength, but the patient sacrifices the ability to bend the wrist. Although wrist joint replacement is newer and less known than hip and knee replacement, the concept is very similar. A wrist joint replacement does not restore normal motion, however it does eliminate pain and it provides a range of motion that is satisfactory for most activities.

Am I a good candidate for this procedure?

The typical patient who is eligible for wrist joint replacement has severe arthritis due to rheumatoid arthritis or osteoarthritis (degenerative joint disease). Some patients with less common causes of arthritis may also benefit from this operation.

Will this surgery limit my activities?

Following this operation, the patient must be willing to somewhat limit his or her activities to avoid the potential complication of device loosening. For example, someone who is actively involved in strenuous labor would not be a good candidate for wrist replacement.

What kind of success can I expect?

The results of wrist joint replacement are predictably good for eliminating and providing a functional range of motion. Patient satisfaction is usually high, and patients are pleased to have wrist motion. However, complications do occur, including infection, dislocation, imbalance and loosening. Although early joint replacements were fraught with these problems, complications have been greatly reduced by newer joint designs.

What kind of prosthetic device is used?

The wrist joint replacement currently used at the University of Iowa is called the Universal 2 total wrist. The prosthesis was developed by Brian D. Adams, MD, professor of orthopaedic surgery, and Nicole M. Grosland, PhD, assistant professor of orthopaedic surgery and biomedical engineering, through the University of Iowa Orthopaedic Biomechanics Laboratory. The UI Orthopaedic Biomechanics Lab has been actively involved in research of the hand and wrist and the development of implants since the 1960s. The research team consists of faculty and professional engineers who work collaboratively with faculty orthopaedic surgeons.

Each phase of development of the Universal 2 included both laboratory testing and computer modeling. The prosthesis, which uses the same materials and some of the same mechanical concepts as in total hip and total knee replacement, is engineered for both performance and longevity. Special features of the prosthesis include the option to implant it without cement when indicated by the physician, minimal bone removal, an offset position within the bone to increase wrist motion and power, and precise instrumentation for accurate insertion.

To learn more about total wrist replacement at the University of Iowa, visit http://www.uihealthcare.com/wristreplacement/