Abstract
Purpose This study aims to report the 5-year survivorship of revision wrist arthroplasties
and to report midterm clinical and radiological results.
Materials and Methods All patients receiving a revision wrist arthroplasty in our unit between January
1, 1997 and October 31, 2010 were identified, and clinical notes retrospectively analyzed
for Quick Disabilities of the Arm, Shoulder and Hand (quickDASH), Patient Evaluation
Method (PEM), Patient-Rated Wrist Evaluation (PRWE), the range of movement, and visual
analog score (VAS). In cases where patient review had not occurred within the past
year, they were invited for assessment, and this data was included in the analysis.
Plain radiographs were analyzed for loosening of each component. The 5-year survival
was plotted using Kaplan–Meier analysis.
Results Of the 19 patients identified, 1 was lost to follow-up and therefore excluded from
all analyses. Mean age at revision wrist arthroplasty was 55.8 years and the mean
time from primary to revision wrist arthroplasty was 6.7 years. At revision arthroplasty,
7 patients received the Biaxial implant (DePuy, Inc., Warsaw, IN) and 11 received
the Universal II implant (Integra, Inc., Plainsboro, NJ). The 5-year implant revision
survivorship was 83%. Depending on the variable of interest, clinical data were available
for either three, four or five patients. At final follow-up (mean: 10.4 years), mean
visual analog score was 2.9, mean quickDASH 57, mean PEM 49, mean PRWE 61, and mean
arc of flexion/extension was 26 degrees. Radiological data were available for 12 patients,
with evidence of gross loosening present in around 60% of the carpal components and
50% of the radial components at mean 6.7 years.
Conclusion Revision wrist replacement implant survival is acceptable, but the majority of the
surviving implants are radiologically loose. It is not clear at this time whether
they are better or worse than a fusion after a failed primary wrist arthroplasty.
Clinical Relevance It is reasonable to offer revision wrist arthroplasty in selective cases, but regular
clinical and radiological follow-up is recommended.
Keywords
clinical outcome - radiological outcome - revision wrist arthroplasty - revision wrist
replacement - wrist replacement survival
