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Universal total wrist implant: Experience with a carpal component fixed with three screws
Affiliation:1. Orthopedic Biomechanics Laboratory, Department of Orthopedic Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Davis Building Rm 6006, Los Angeles, CA 90048, USA;2. Medtronic Spinal Applied Research, Medtronic Spine, 2600 Sofamor Danek Dr, Memphis, TN 38132;3. Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1520 San Pablo St, Suite 3800, Los Angeles, CA 90033, USA;1. Department of Orthopaedic Surgery, Woodlands Health, Singapore;2. School of Mechanical & Aerospace Engineering, College of Engineering, Nanyang Technological University, Singapore;3. Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore
Abstract:The Universal Wrist Implant was used to treat 31 patients (37 wrists), who had symptoms indicating pancarpal arthritis of the wrist, diagnosed as total wrist arthroplasty. Their mean age was 58.1 years. Follow-up ranged from 48 to 120 months with a mean of 79.4 months (6.7 years). The carpal component of the Universal Total Wrist is fixed to the carpus by titanium screws. Unlike other total wrist prostheses, the primary fixation of the carpal component is in the capitate and not in the third metacarpal. Intercarpal fusion provides a solid bony support for the carpal plate and results in improved longevity. Articular surface of the radial component is inclined 20°, similar to the articular surface of the radius. Components can be inserted with or without cement. In three patients, the prosthesis had to be removed due to infection and persistent dislocation. Of the remaining 34 wrists, 30 (88%) achieved excellent pain relief. Complications occurred in 12 cases (32%). Of these 12 complications 9 (75%) resolved with appropriate treatment. The most common complication with this nonconstrained prosthesis was dislocation. The Universal Total Wrist Implant provides a predictable option to preserve motion and relieve pain when managing wrist joint arthritis.
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