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
