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J Wrist Surg 2024; 13(04): 339-345
DOI: 10.1055/s-0043-1777408
Scientific Article

Increasing Use of Total Wrist Arthroplasty—An Australian National Joint Registry Report

Fraser Taylor
1   Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, Queensland, Australia
2   Griffith University School of Medicine and Dentistry, Southport, Queensland, Australia
,
Bradley David Gilpin
1   Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, Queensland, Australia
3   Orthopaedic Department, Princess Alexandra Hospital, Woolloongabba, Australia
,
Brahman Shankar Sivakumar
4   Discipline of Surgery, Sydney Medical School, the Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
5   Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Queensland, Australia
6   Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
7   Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia
8   Department of Orthopaedic Surgery, Nepean Hospital, Kingswood, New South Wales, Australia
,
Carl Holder
9   Australian Orthopaedic Association, National Joint Replacement Registry, Adelaide, South Australia, Australia
,
Richard Page 
9   Australian Orthopaedic Association, National Joint Replacement Registry, Adelaide, South Australia, Australia
10   Barwon Centre of Orthopaedic Research and Education (B-CORE), School of Medicine, Deakin University, Geelong, Victoria, Australia
11   St John of God and Barwon Health Professorial Chair of Orthopaedic Surgery – SJOG Hospital and Deakin University, Victoria, Geelong, Australia
12   Department of Orthopaedic Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
,
David James Graham
1   Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, Queensland, Australia
2   Griffith University School of Medicine and Dentistry, Southport, Queensland, Australia
5   Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Queensland, Australia
13   Department of Orthopaedic Surgery, Queensland Children's Hospital, South Brisbane, Queensland, Australia
14   School of Medicine, University of Queensland, Herston, Queensland, Australia
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Abstract

Background and Purpose There is limited literature reporting the long-term results and outcomes of total wrist arthroplasty (TWA). The aim of this study was to describe the incidence, usage, and survival of wrist arthroplasty using data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).

Methods Data included all primary TWA procedures from 2006 to 2021. The primary outcome assessed was revision surgery. Utilization of TWA, etiology leading to TWA, patient demographics, and surgical factors were also assessed.

Results There were 439 primary TWA procedures performed across the 16-year reporting period. Four prostheses (Motec, Universal 2, Freedom, and ReMotion) have been used, with a recent increased usage toward the Motec, which accounted for 97.4% of prostheses implanted in 2021. There has also been an increase in the number of surgeons performing TWA over time. The most common underlying etiology was osteoarthritis (72.7%), followed by rheumatoid arthritis (15.9%). Implantation for inflammatory arthropathy remained relatively constant across time; however, TWA has been utilized with increasing frequency for the treatment of osteoarthritis and other indications more recently. The cumulative percent revision at 10 years was 18.3%. Loosening accounted for 25.6% of all revisions, followed by osteolysis (12.8%), pain (12.8%), and instability (7.7%). Attempted conversion to an arthrodesis occurred in 10.3% of all revisions.

Conclusion There has been an increase in both the volume of TWA performed and the number of surgeons undertaking this procedure in Australia over the past 16 years. The Motec system has become the prosthesis of choice. Medium-term revision rates are inferior when compared with Australian data for hip, knee, and shoulder arthroplasty.

Keywords

wrist - carpus - arthroplasty


Publication History

Received: 24 April 2023

Accepted: 09 November 2023

Article published online:
31 January 2024

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