Download PDF
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
› Author Affiliations
› Further Information
    Permissions and Reprints

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

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Ritt MJ, Stuart PR, Naggar L, Beckenbaugh RD. The early history of arthroplasty of the wrist. From amputation to total wrist implant. J Hand Surg [Br] 1994; 19 (06) 778-782
    CrossrefPubMedGoogle Scholar
  • 2 Meuli HC. Reconstructive surgery of the wrist joint. Hand 1972; 4 (01) 88-90
    CrossrefPubMedGoogle Scholar
  • 3 Ferlic DC, Clayton ML. Results of CFV total wrist arthroplasty: review and early report. Orthopedics 1995; 18 (12) 1167-1171
    CrossrefPubMedGoogle Scholar
  • 4 Chakrabarti I. Total wrist arthroplasty: a review. J Hand Microsurg 2009; 1 (02) 72-75
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Divelbiss BJ, Sollerman C, Adams BD. Early results of the Universal total wrist arthroplasty in rheumatoid arthritis. J Hand Surg Am 2002; 27 (02) 195-204
    CrossrefPubMedGoogle Scholar
  • 6 Giwa L, Siddiqui A, Packer G. Motec wrist arthroplasty: 4 years of promising results. J Hand Surg Asian Pac Vol 2018; 23 (03) 364-368
    CrossrefPubMedGoogle Scholar
  • 7 Rothe CJ, Sivakumar BS, Buchan CA, Graham DJ. Metal-on-metal disease in high-motion wrist arthroplasty. Hand (N Y) 2022; 17 (02) NP11-NP16
    CrossrefPubMedGoogle Scholar
  • 8 Vakalopoulos K, Arner M, Denissen G. et al. Current national hand surgery registries worldwide. J Hand Surg Eur Vol 2021; 46 (01) 103-106
    CrossrefPubMedGoogle Scholar
  • 9 Krukhaug Y, Lie SA, Havelin LI, Furnes O, Hove LM. Results of 189 wrist replacements. A report from the Norwegian Arthroplasty Register. Acta Orthop 2011; 82 (04) 405-409
    CrossrefPubMedGoogle Scholar
  • 10 Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR]. 2022 Demographics and Outcomes of Elbow and Wrist Arthroplasty Supplementary Report. Accessed October 4, 2022 at: https://aoanjrr.sahmri.com
    PubMedGoogle Scholar
  • 11 Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR]. 2022 South Australian Health and Medical Research Institute. Accessed October 4, 2022 at: https://aoanjrr.sahmri.com
    PubMedGoogle Scholar
  • 12 Elbuluk AM, Milone MT, Capo JT, Bosco JA, Klifto CS. Trends and demographics in the utilisation of total wrist arthroplasty. J Hand Surg Asian Pac Vol 2018; 23 (04) 501-505
    CrossrefPubMedGoogle Scholar
  • 13 Verstappen SM, Hoes JN, Ter Borg EJ. et al. Joint surgery in the Utrecht Rheumatoid Arthritis Cohort: the effect of treatment strategy. Ann Rheum Dis 2006; 65 (11) 1506-1511
    CrossrefPubMedGoogle Scholar
  • 14 Reigstad O, Holm-Glad T, Bolstad B, Grimsgaard C, Thorkildsen R, Røkkum M. Five to 10 year prospective follow-up of wrist arthroplasty in 56 nonrheumatoid patients. J Hand Surg Am 2017; 42 (10) 788-796
    CrossrefPubMedGoogle Scholar
  • 15 Boeckstyns M, Herzberg G, Merser S. Favourable results after total wrist arthroplasty. Acta Orthop 2013; 84 (04) 415-419
    CrossrefPubMedGoogle Scholar
  • 16 Sagerfors M, Gupta A, Brus O, Pettersson K. Total wrist arthroplasty: a single-centre study of 219 cases with 5 year follow up. J Hand Surg Am 2015; 40 (12) 2380-2387
    CrossrefPubMedGoogle Scholar
  • 17 Fischer P, Sagerfors M, Jakobsson H, Pettersson K. Total wrist arthroplasty: a 10-year follow-up. J Hand Surg Am 2020; 45 (08) 780.e1-780.e10
    CrossrefPubMedGoogle Scholar
  • 18 Badge R, Kailash K, Dickson DR. et al. Medium-term outcomes of the Universal-2 total wrist arthroplasty in patients with rheumatoid arthritis. Bone Joint J 2016; 98-B (12) 1642-1647
    CrossrefPubMedGoogle Scholar