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J Wrist Surg 2022; 11(04): 335-343
DOI: 10.1055/s-0041-1740135
Scientific Article

Midterm Functional Outcome of the Linked Semiconstrained Distal Radioulnar Joint Prosthesis

Jaak Warlop 
1   Faculty of Medicine, University Hospitals Leuven, Belgium
,
Maarten Van Nuffel
2   Unit of Hand, Wrist and Elbow Surgery, University Hospitals Leuven, Leuven, Belgium
,
Luc De Smet
2   Unit of Hand, Wrist and Elbow Surgery, University Hospitals Leuven, Leuven, Belgium
,
Ilse Degreef
2   Unit of Hand, Wrist and Elbow Surgery, University Hospitals Leuven, Leuven, Belgium
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Funding None.
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Abstract

Background A painful unstable distal radioulnar joint (DRUJ) can seriously compromise hand and wrist function. The semiconstrained prosthesis was developed to restore DRUJ function. To date, most outcome reports are coauthored by the designer.

Questions Does independent reporting confirm the promising results of the semiconstrained DRUJ prosthesis? Are complication and failure rates acceptable?

Patients and Methods We evaluated patients with the semiconstrained DRUJ implant and a minimum follow-up of 2 years. We monitored patient satisfaction and function with functionality questionnaires and measured wrist range of motion, grip, and key pinch strength. Statistical analysis was done using descriptive statistics, Pearson correlation coefficients, linear and logistic regression.

Results We included 41 patients with 42 implants. Mean follow-up was 46 months (range: 24–102 months). Eighty percent of wrist had undergone previous surgery. We found a mean pronation of 83 degrees (0–90 degrees), supination of 70 degrees (0–90 degrees), flexion of 42 degrees (0–90 degrees), extension of 49 degrees (0–90 degrees), ulnar deviation of 24 degrees (0–60 degrees), and radial deviation of 14 degrees (0–40 degrees). Grip and key pinch strength were 20.1 (1–50 kg) and 6 kg (1–12 kg), respectively. Average patient-rated wrist and hand evaluation score was 42.7 (0–95), disabilities of the arm, shoulder and hand score was 38 (0–88), and visual analog scale score was 3.6 (0–8). We found a 43% complication rate (mostly minor: ulnar or radial tendinopathy, temporary hypoesthesia) with 24% reoperation and 92% prosthesis survival rate.

Conclusion The linked semiconstrained DRUJ prosthesis has its value in the surgical treatment of DRUJ failure. Currently, most implants are used in secondary surgery and multioperated wrists. More research is required to assess the value of the DRUJ prosthesis as a primary procedure.

Level of evidence This is a level IV, therapeutic study.

Keywords

distal radioulnar joint - joint replacement - arthroplasty - semiconstrained - outcome - complications

Notes

Written informed consent was obtained from all subjects before the study.


J.W. and I.D. have provided guarantee for this manuscript.


Ethical Approval

Ethical approval for this study was obtained from the university hospitals institutional review board (S58242).


Authors' Contributions

I.D. was involved in protocol development, gaining ethical approval, patient recruitment, data analysis, and critical review of the first draft. J.W. wrote the first draft of the manuscript and was involved in patient recruitment, data analysis, literature research, writing the first draft and implementing the critical reviews of other authors in writing the final draft. M.V.N. and L.D.S. were involved in patient recruitment and critical review. All authors reviewed and edited the manuscript and approved the final version of the manuscript.




Publication History

Received: 20 March 2021

Accepted: 12 October 2021

Article published online:
13 December 2021

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